NHSScotland waiting times guidance: November 2023

This guidance replaces the previous waiting times guidance (2012) to support health boards in the delivery of the national waiting times standards. The guidance will continue to make sure that patients who are on waiting lists are managed fairly and consistently across NHSScotland.

9. Booking Methods

Booking Methods

Across NHSScotland a number of booking methods are used for scheduling appointments and admission dates. Health Boards must ensure that their chosen approach to booking appointments is effective, to allow for efficiency across their organisation, in order to deliver safe and reliable services for patients.


Each Health Board is responsible for ensuring that the method(s) selected for scheduling appointments locally, meets the waiting time standards or Treatment Time Guarantee. Booking methods also need to consider the criteria for a reasonable offer of appointment and the guidance under ‘Communication with Patients’ and ‘Additional Support Needs’.

9.1 Patient-Focussed Booking


Patient-Focussed Booking (PFB) is a scheduling process whereby a communication is sent to a patient inviting them to get in contact to make arrangements for their appointment.

The process of Patient-Focussed Booking is shown below.

  • An initial communication inviting the patient to get into contact is sent by the Health Board.
  • A reminder must be sent after 14 calendar days, if the patient has not made contact.
  • At this point PFB Unavailability will start for new outpatients.
  • If there is no appointment made after a further 7 calendar days from the reminder was issued (totalling 21 calendar days), TTG patients must be provided a reasonable offer of appointment. At which point the guidance for both reasonable offers and patient refusals should be followed.

Best Practice

In certain circumstances, for example postal strikes or festive periods, it may be appropriate for the Health Board to extend the timescales for a patient response.

Figure 2:

  • Communication issued asking patient to make contact to arrange appointment.
  • Reminder to be sent 14 calendar days after the original correspondence is issued if no appointment made by the patient.
  • After a further 7 calendar days, if no appointment made by TTG patients, then the Health Board should provide a reasonable offer of appointment.

9.2 Implied Acceptance

Implied Acceptance is a scheduling process whereby an appointment is made on behalf of a patient and issued to them. This is a reasonable offer, and should follow the criteria set out for Reasonable Offers.


If no response has been received by the Health Board within 10 calendar days of the appointment being issued, it is then assumed that the patient has accepted the appointment.

The process for implied acceptance is shown below:

Figure 3:

  • The patient is issued a communication with an appointment made on their behalf along with information on how to reschedule if the appointment is unsuitable.
  • If the patient does not respond to the Health Board within 10 calendar days following receipt of this communication, either accepting or to reschedule, it is assumed that they have accepted this appointment.


This offer of appointment would be classed as one reasonable offer:

  • if the patient does not attend, it should be classed as a Did Not Attend (DNA)
  • if the patient gets in contact and cancels within 10 days, it would be classed as a refusal.
  • if the patient gets in contact and cancels after 10 days, it would be classed as a Could Not Attend (CNA).
  • if the patient cancels three or more agreed appointments, the CNA process should be followed by Health Boards.


Email: waitingtimespolicy@gov.scot

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