C1Chase & Expiry Loop

Purpose

The single method used to chase a patient for anything outstanding, and what happens when chasing runs out. Any SOP that says “chase using C1” means this procedure.

Procedure

1. Add the patient to the relevant tab with the standard fields.
2. Set an ad-hoc reminder in Semble for the outstanding item and let the Semble automations run.
3. Wait the standard interval for that pathway - 1 week for observations, monthly for investigations, otherwise as set on the tab.
4. If nothing is received, phone the patient. Log the date chased and increment the chase count.
5. Repeat step 4 at the pathway's chase interval until either the patient responds (record the date, mark complete, row filters out - loop ends) or the reminder expiry date is reached.
6. At expiry, take the case to the Daily Brief or MDT (C4). Neither an 8-week warning nor a discontinuation may proceed without that discussion.
7. On MDT approval, route to C2 (8-week non-engagement warning).

Fields recorded

NHS number · name · DOB · funding stream · what is awaited · date added to tab · date reminder set · date of each chase · number of chases · reminder expiry date · date of patient response · status / outcome

Variations

Observations - First phone attempt after 1 week. If the patient rings in to book an obs call, record the date and the loop ends.

Investigations / ECG - Chased monthly. If chased more than 6 times, escalate to MDT regardless of the expiry date. Also tracks date request letter sent, date letter sent to GP, and last appointment date.

Questionnaires - The list is checked one week before the appointment. Reminders go by email and phone together.

Shared care 6-monthly obs - The obs-due column is sorted chronologically to find who is coming up. Chasing stays on the Shared Care tab and does not move to the Observations tab.

Titration / prescriptions - The appointment requirement and the obs requirement each run their own instance of this loop in parallel, with separate expiry dates.

Notes

• A response at any point ends the loop immediately - the patient is filtered out and the pathway resumes.
• The reminder expiry date is where automation stops and a human decision is required. It is not an automatic discharge.

Flowchart