Very simply, PFB puts patients at the heart of the booking process by engaging them in dialogue about their appointment. Previously, patients would be sent an appointment letter, with the date and time of their appointment, no matter how far ahead in time that may have been. When the appointment day came, patients may have no longer required the consultation, may have forgotten to turn up or booked clinics may have been cancelled.

With PFB, patients are sent an invitation letter, inviting them to telephone or email the hospital to arrange a suitable date and time for an appointment within current guarantee time guidelines. The process is complemented by a policy that prevents a clinic being cancelled with less than six weeks' notice. Therefore, when the patient phones or emails, the appointment options are limited to only those clinics scheduled in the next few weeks (non-routine patients are clinically prioritised to by-pass this process and will always be seen first).

The call operator offers a choice of dates and times and the patient chooses the most convenient to them. After a period of 7 days, if the patient fails to phone a reminder letter will be sent, after checking contact details, if the patient fails to respond to the reminder letter after a period of 7 days a further letter is sent to the patient and their GP, explaining that they have been removed from the waiting list.