Contracts for Innovation Cymru - Reducing Missed Appointments and Improving Access to Planned Care

Challenge Overview

Cwm Taf Morgannwg University Health Board (CTM UHB) experiences persistently high rates of missed outpatient appointments, with approximately 64,000 appointments missed over the last 12 months. These missed appointments create challenges for patients and services alike, contributing to longer waiting times, underutilised clinical capacity, financial inefficiencies and poorer patient experience.

CTM estimates that missed appointments may account for approximately £9.6 million of avoidable lost value each year, representing a significant opportunity to improve both patient access and the use of NHS resources.

Evidence suggests that non-attendance is often linked to a range of practical, behavioural, communication and accessibility barriers rather than a simple choice not to attend. These barriers can include challenges associated with appointment communication, transport, geography, caring responsibilities, socioeconomic factors, digital exclusion, health inequalities and service design.

Contracts for Innovation Cymru (CfIC) is seeking innovative solutions that help people overcome these barriers, reducing missed appointments whilst improving access to planned care.

The challenge is deliberately open and does not prescribe a particular technology, product or service. We welcome ideas from a wide range of sectors and disciplines and encourage applicants to think creatively about how attendance, access and patient experience can be improved.

We are seeking innovative approaches that help reduce missed appointments and improve access to planned care.

Solutions may address one or more aspects of the challenge, including but not limited to:

• Appointment communication and engagement
• Accessibility of information
• Appointment planning and management
• Behavioural approaches that encourage attendance
• Identification of individuals at increased risk of non-attendance
• Travel and accessibility barriers
• Digital tools and services
• Community-based support models
• Service and pathway redesign
• Data-driven approaches to improve attendance and access

Applicants are encouraged to consider how different barriers interact and how solutions may support a diverse population with differing needs and circumstances.

We are not seeking a predetermined solution and welcome a broad range of innovative approaches.

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In Scope

We are interested in solutions that can contribute to one or more of the following:

• Improving appointment attendance and reducing missed appointments.
• Improving access to planned care services.
• Appointment communication and engagement.
• Accessibility of information and services.
• Appointment planning, scheduling and management.
• Behavioural approaches that support attendance.
• Identification of people at increased risk of non-attendance.
• Reducing practical barriers to accessing services.
• Data-driven, digital or technology-enabled approaches.
• Community-based or service redesign approaches.
• Improving equity of access across different populations and geographic settings.
• Welsh language, accessibility and inclusive service delivery.

Out of Scope

We are not seeking projects that:

• Focus solely on increasing demand for healthcare services.
• Are primarily academic or research studies with no credible route to implementation.
• Require extensive fundamental research before development can commence.
• Cannot demonstrate a realistic route to adoption within health and care services.
• Do not consider affordability, scalability or long-term sustainability.
• Rely solely on English-language patient-facing delivery.
• Seek to replace appropriate clinical oversight or professional judgement where this remains necessary.

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Desired Outcomes

Successful solutions should demonstrate potential to deliver measurable improvements in one or more of the following areas.

Patients and Citizens

• Improved access to planned care services
• Increased appointment attendance
• Improved patient experience
• Reduced travel and logistical burden
• Better health outcomes through more timely access to care
• Fairer access irrespective of location, income or personal circumstances

Staff

• Improved clinic utilisation
• Reduced administrative burden
• More effective use of clinical time
• Improved operational efficiency

Health and Care Systems

• Reduced DNA rates
• Improved productivity and service flow
• Reduced waiting times
• Better use of public resources
• Reduced health inequalities
• Improved sustainability and environmental outcomes

Potential measures of success may include attendance rates, service utilisation, waiting times, patient experience, equity measures, operational efficiency and value for money.

Funding and Support

Phase 1 Funding

Funding Available: £200,000 total budget to support a portfolio of projects.

The total funding available for the competition can change and the funders reserve the right to adjust the provisional funding allocations, i.e., should additional funding become available.

Number of Projects: Current funding is available to support a portfolio of projects, dependent upon the number/quality of submissions received.

Portfolio Approach

Funding decisions may be made using a portfolio approach, recognising that complex challenges often require a range of complementary solutions rather than a single intervention. Consideration will be given to the overall balance of projects supported, the evidence generated and the potential for wider adoption and learning across Wales.