Better/intelligent NHS PR forms

Hi ​@DavidB  👋

Thanks for sharing your feedback, this is a great list! I’ve split it into themes so we can track each item with Product and keep this thread updated even though they’re all related.

To recap what you’d like to see:

• Pick a family member for “If you are signing for the patient…” from existing linked family members.

• A richer relationship list (mother, father, step-parent, grandma, foster carer, carer, etc.).

Smarter PR form logic including:

• Let patients select their exemption directly on the PR form.

• Skip the extra confirmation screen and make the PR form itself interactive.

• If maternity exemption is chosen, require due date/baby DOB.

• If age < 18, force “Under 18” and hide invalid exemptions.

• If HC3, require the HC3 amount.

• Allow choosing an acceptance date for back-dating FP17PR when correcting exemptions (with audit).

I’ll log all of these as separate items on our NHS PR forms improvements request and loop in our PM so they can be considered. No timelines to share yet, but I’ll keep this post updated as things move.

If you also clarify a couple of things it would be great as it helps me loop in our Product team 😊:

• Workflow: would you expect patients to complete this via Concierge/Portal before the appointment, or chairside on the iPad?

• Back-dating: how far back do you need to set the acceptance date in practice (days/weeks), and how often does that come up?

If other practices would benefit from this, please add a quick 👍 or comment below and whether you want patients to self-complete via Concierge/Portal or at the desk. The more examples we have, the easier it is to prioritise. 🙏

Thanks for your interest… I think all NHS practices would benefit from PR form validation and enabling patients to do more themselves and so free up time for team members.

The initial confirmation screen is a superfluous step that could be completely eliminated/streamlined if the PR form itself was interactive. I assume the NHS requires you to display all of the information from the PR form without hiding any of it, but you could certainly disable invalid options, and add validation messages for incomplete dependant/required fields. If the NHS doesn’t insist you need to display the whole PR form as is, then it might be easier to use if you to make your own nicely formatted dynamic version that is more visually digestible for patients and confirms whether patients might have an exemption from NHS charges before displaying only the valid exemption options for their age (and potentially their sex at birth).

It’s great when patients complete PR forms before attending - to save time at reception and avoid wasted time in surgery - so portal integration is definitely very desirable. Some patients won’t use the portal though ...so in reception on the iPad app is also essential. Ideally dental teams would not need to help patients compete PR forms to save time and eliminate the potential accusation that we put down the wrong exemption, so the more intuitive they are, the better. Currently reception have to fill out the forms, and often even open the signature box for the patients to sign blindly.

The main reasons we need backdated PR forms are when invalid exemptions are selected or required fields are left empty leading to instant rejection of the claim. This would usually be noticed in the few days following completion of treatment ...but completion of treatment could be months after the initial appointment when the PR form was signed.

Hi ​@DavidB,

This is super helpful, thanks for clarifying. I’ll have a chat with our Product team and see if I can get a better understanding of where we are with this and I’ll let them know they can reach out to you for additional info. I’ll keep this thread updated for any new developments 😊

Regarding invalid PR / FP17 forms, we have this problem frequently as patients have sometimes accidently selected the wrong option e.g. prisoner insread of pensioner or Universal Credit instead of Pension Credit.   Please explain to me what the practice is to do in this situation because I have not received a valid reply when I have queried this before with support.

It’s not acceptable that we cannot go back and change the form or the patient submit a new one when using the Concierge app.  What my staff do instead, is revert to the old (not properly working) ipad app (blue dentally icon) and force through a new PR form.  This should not be the way and its imperitive that this is fixed as soon as possible because otherwise our NHS claims are being invalidated and furthermore we do not have an accurate PR form.   

Can anyone please confirm if the exemption is invalidated in Dentally under the NHS tab or by deleting the PR form in correspondance, will this enable the patient to do the FP17 / PR form again - I dont think so?

Also another common pain point is a family booking where a parent is unable to complete the PR or medical forms for several family members attending at the same time.  I know Dentally likes to make money by sending multiple text messages when doing it via the portal, but this is both not fair and not efficient - why can the parent not complete all forms without having to log out of each account and login again with the email sent to each family member.  This is basic and the workflow needs to be improved for the portal and for Concierge.

I see that some changes were recently made to the form which closes off the point about exemptions be shown for a patient under the age of 18 - this is a great first step to avoid having wrong exemptions accidently in place.  If we could please implement more of the above, it would be great.

​@Saymon just wanted to make sure you saw my above comment and if you are able to pls help with some suggestions to my questions, thanks.

Hi, 

I work with the product teams here and I’ll jump in as Saymon is currently on leave. 

The best way to deal with an invalid PR form currently, as you suggest is to remove the PR from the patient’s correspondence records. This will trigger the Concierge and Portal to ask for another. Removing the PR will not also remove any exemption added as part of that PR, but that exemption should be deletable from the NHS Exemptions screen if it has not been used as part of an NHS claim. 

The concept of grouping family members to allow for the completion of all forms as part of a single login is a great idea and one which we agree would help with efficiency. It’s an area we do want to improve and I will definitely ensure that your feedback is raised with the relevant product team.

​@KevinBell Hi - any update on some of these suggestions including updating of family medical and PR from one account?

​@BCDC2023 thanks for checking in. The product team have confirmed to me that they’ll be looking to make improvements to forms and online signing once the upcoming work on online booking has been released, and they’ll take all the feedback in this post into consideration when planning those enhancements in the coming months. 

Hi

Since the mandatory introduction of patient ethnicity on the NHS form on the iPad and online, there has been a massive delay and increase in patients taking time to complete the NHS forms on the concierge in the Practice if they have not done it online. 
 

Why oh why are patients being asked to complete their ethnicity EACH AND EVERY time they do the form when they have completed previously and dentally is showing it in the patient details screen?  It’s not as if their ethnicity changes between each visit.

The long list of ethnicities has added a good 1+ minute at reception for every patient who needs to scroll up and down the list looking for their correct ethnicity and when they’re running late, we hear them swearing and getting frustrated saying they’ve done this many times before and “why don’t you fix your IT system”. 
 

Many patients don’t want to do give their ethnicity and this is their right.  Could we please introduce (as the first option at the top of the list) that the patient has declined the request to confirm ethnicity?

But MOST importantly, if dentally has their ethnicity (from having previously completed this information, it should be pulling it again into future NHS forms.   Also why does it ask for their name and date of birth as they fill it in - this can also be automatically pulled in?  Huge waste of time making patients do it again.  Concierge and online portal was supposed to make life easier for practices and we’re paying for this feature - since these changes were introduced several months ago, we’ve gone 5 steps back in terms of efficiency.  

Hi,

The patient ethnicity option will be presented to the patient each time when completing a PR form, however the patient should not be forced into entering a new value unless there was no previous entry recorded.

This did change, however with the introduction of new ethnicity values (including options for Ethnicity not stated and Ethnicity not known) in April this year. The guidance we were given by NHSBSA with the introduction of these new options and the removal of previous, more ambiguous options, was that the ethnicity option for any patients with what became outdated options should not be automatically replaced and that there should now be no ‘default’ option for a patient not to state their ethnicity - ie, where there was previously no stated option, an answer must now be gathered (even if that response is not to state it) and that a previous answer of ‘Unknown’ could not be carried forward as an answer.

This does, obviously have the effect of a lot of patients now needing to specifically state their ethnicity, where previously they had chosen not to, or had simply not answered and allowed the defaulted answer as not known. These newly recorded answers should carry forward to any future PR forms though.

Hi Kevin,

Thanks for your email.  

Unfortunately you're mistaken on this issue about how the system behaves on this point.   I can confirm that the ethnicity is being asked each and every time the patient fills in the FP17 form even after the new changes have been implemented.  

Could I please ask you to double check with a real patient or in the sandbox environment.   We've spoken about incorrect onboarding issues in the past and issues with our ICB as part of a PAR but and we've got 2 NHS contracts with one being a referral.  When we refer our own patient back to is for specialist surgery within an hour of the first appointment, the same patient has to complete a new FP17 form even an hour after the first one.   They are being asked to complete their ethnicity again having done it an hour earlier.  

I've also tested this with duplicate patients several hours and several days after their first appointment in this week and the same issue applies.  Please check and reconfirm.  

Also could I pls request the option for a patient to decline giving their ethnicity is put at the very top.  Unless NHS have insisted that this option be placed at the bottom of the list, I dont see why Dentally cannot make practice staff's lives easier by keeping it at the top.  It's not costing anyone anything and creating a lot of disgruntled patients and staff being increasing the time taken to complete forms.   

Is there a reason why names cannot also be pre-populated?  I know these all seem like minor things but every click, type etc especially at reception adds time and believe me when I say, watching patients scroll up and down the ethnicity list getting frustrated and swear is not pleasant for anyone.  We can still comply with NHS bureaucracy by making a patient experience much better by placing options in easy reach.  

Thanks for the response. It certainly sounds like the PR workflow is not working as expected in practice.

I have passed this on to the Product Manager in charge of this area and we will investigate.