Dive into operations with Milica Stjepanovic
Meet Milica Stjepanovic who is playing a key role in the transformation of our outpatient services. She is working on the new 'choice booking' process for our outpatient services.
Tell us a little about yourself
Hi! I’m Milica – though most people at the Trust know me as Mel. I’m currently the Divisional operations manager for Women’s, cardiac, clinical support and sexual health services (WCCS), and I’m responsible for delivering our centralised outpatient function across the organisation. A fun fact, before diving into healthcare, I was literally diving. I was a professional 10m platform diver (a very long time ago!).
I’ve been with the Trust for just under 10 years now. I started out as a Cerner floor walker – supporting the rollout of the digital system across the Trust – and have worked my way through a range of roles ever since. Along the way, I completely fell in love with operational management – particularly the power that systems and processes have to enable great patient care.
Do you have a typical working day?
If only! Like most managers, my day is often full of meetings, which are essential for collaboration and decision-making. I also make sure to carve out time for the ‘doing’ too. I absolutely love working hands-on with the amazing teams around me. Whether it’s shadowing in the call centre, problem-solving with service leads, or coaching team leaders, that face-to-face time is what fuels me. Each morning I wake up excited to tackle the outpatient backlog – not just to reduce numbers, but to help ensure the right patient is in front of the right clinician at the right time with the right information. That’s what gets me out of bed.
What does the patient service centre do?
The patient service centre (PSC) – in my opinion – is one of the most exciting and hardworking teams in the Trust. We have just under 160 administrators who manage over 45,000 calls a month, book thousands of appointments, and schedule more than 70 per cent of our theatre patients. That’s a massive task, supporting a population of 2.5 million people across north west London. One of my favourite things is getting out to see the teams in action – I aim to spend at least one day a week visiting teams across our hospital sites to say thank you and remind them just how instrumental they are to delivering exceptional care.
What are some of the challenges that patients face with their appointments?
Unfortunately, the system wasn’t built with technology in mind. We’re working with outdated, rigid processes that often require rescheduling appointments an average of three times per patient without actually talking to the patient even once. It’s no wonder people get lost in the system or do not trust the system, which comes with multiple waiting lists, multiple letters, unclear information, and very little flexibility. Patients don’t want complexity, they just want to know when their appointment is and if necessary, how to reschedule it. And this is what we are trying to give them through the choice booking pilot.
Tell us more about the choice booking pilot
The choice booking pilot was our bold attempt to flip the model – and give our patients choice. Inspired by the 6-4-2 concept used in theatre scheduling, we created an 8-6-4-2 model for outpatient bookings. The idea is to bring order and predictability to the chaos:
- 8 weeks out – every patient gets asked the question, ‘Do you still need an appointment?'
- 6 weeks – capacity is locked and patients are called to book an appointment at a mutually agreed time and date
- 4 weeks – patients who have not replied are sent letters asking them to engage with us
- 2 weeks – one last letter is sent to patients, and all un-booked slots are being used for short term urgent appointments
Piloting this wasn’t easy. We had to change everything – how the patient service centre is structured, how operational managers work, and how patients interact with us, in addition to how consultants plan their clinics. It wasn’t all smooth sailing, but the team truly rose to the challenge. Everyone recognised the challenge we have with DNAs (do not attends), as well as hospital and patient-initiated cancellation – the pilot means our patients are informed and engaged with the booking process. With open minds, lots of laughter, and a ‘fix it fast’ mindset, we worked through errors, took on feedback, and embraced every lesson.
And it’s working – we’re seeing improved booking efficiency, reduced last-minute changes, and most importantly, happier patients who feel like they’ve been given real choice.
How are you considering equity in the pilot?
Equity is baked into everything we’re doing. We know not every patient has digital access or speaks English fluently, so the pilot includes phone-first booking and flexibility in appointment times to suit carers, working people, and those with complex needs.
Next up is a wider rollout with a digital choice booking. The goal is to offer multiple access routes so that patients can either manage their booking online or speak to someone directly. It’s all about choice, flexibility, and designing with real lives in mind.
This process isn’t set in stone. Like everything under the continuous improvement umbrella, it will evolve and together with all our staff from different backgrounds we’ll keep making it better, because that’s what our patients deserve – a flexible system that meets their needs.
And finally, what dish would you bring to a potluck lunch?
Easy! A big piece of ribeye steak, medium rare, with a hot honey halloumi salad on the side. It’s bold, a bit indulgent, and guaranteed to make people happy – which, let’s be honest, is the goal of any good meal and any good ops transformation!
