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Health Matters - Referral Management System

Lucy Price thumbnail
Health Matters - Referral Management System
27 December 2017

Lucy Price, clinical project manager for the new referral management system at NHS Eastern Cheshire CCG 

One of our priorities is to ensure people get the right care in the right place at the right time and that they are treated as close to home as possible.

As part of this work, we’re following an “elective care high-impact interventions programme” developed by NHS England to ensure a consistent national approach when patients are referred to hospital outpatient departments for appointments about planned surgery. 

Our work involves developing a referral management system for the following six key specialties:

  • Cardiology
  • Gastroenterology (stomach and intestines, liver, gall bladder and pancreas)
  • General Surgery (includes stomach, small bowel, colon and appendix)
  • Ophthalmology
  • Orthopaedics
  • Paediatrics

The referral management system will feature the following:

  • IT software (Integrated Care Gateway) – to support the processing of referrals from submission by the GP practice to the review by a clinical triage service, followed by the booking of an appointment with the relevant service.
  • Clinical triage service - each specialty will be supported by consultants specialising in that area to ensure that the patient is provided with the right treatment and at the right time.
  • Booking service – once the clinical triage has confirmed that the patient requires specialist treatment, a referral will be sent through to the booking team. The team will contact the patient to make the appointment.

Benefits include: 

  • More patients seen in the right place at the right time
  • Patients and carers not having to visit hospital unnecessarily
  • Wider patient choice of service provider and dedicated time to talk through reasonable adjustments, for example to help people with a learning disability access the services they need
  • Standardised process
  • Improved quality of referrals.

The system will also help the CCG to ensure best value for money by reducing inappropriate referrals for hospital services.

The project will go live in April 2018. And we’ve started working with local patient groups to ensure that key messages are communicated clearly.

Dr Paul Bowen, our clinical chair, and GP with McIlvride Medical Practice, Poynton explains why our new referral management system is good news for patients and health professionals alike:

The changes outlined by Lucy Price have been developed by and in partnership with local GPs and consultants. The proposed system was approved by our Governing Body on 27 September 2017 and supported by patients at a public engagement event we held on 13 December 2017. We are introducing a level of support for GPs and their patients that refines and improves the quality of referrals to make sure patients see the right specialist with the right level of urgency, and have had all necessary tests and treatments before that appointment.

GPs will be able to seek advice directly from specialists and use software which makes the whole process more reliable and user friendly for patients and practices, which can still bypass the system and refer directly if preferred. This in turn should free up more GP time and reduce wasted hospital appointments, as evidence from other areas has demonstrated.

The NHS is constantly changing, and needs to. As a GP myself, knowing who, where, when and how to refer to some services is sometimes mind boggling. New technologies, treatments, specialists and clinics become available each week – this system will help.

GPs and their colleagues working in specialist nursing, physiotherapy, diagnostics and other community-based therapies are now able to provide so much more care in patients’ own communities than even when I was a hospital doctor. The “community” should not be considered a second class environment for care, and our hospitals must not be the only place where specialist, crisis or complex care is delivered. For none of us wants to travel to hospital if some or all of that specialist and generalist care can be delivered closer to our homes in a more safe, effective manner. And when we do need specialist care, we often want it from the service that excels at that specialism.

The NHS wastes millions on needless, duplicative, expensive and wasteful appointments and treatments which could be avoided with systems and approaches like this.

It is important that the public has the correct, objective and evidence-based information to help form opinions on any changes to the way the NHS currently provides care, or is planning to. I would encourage people to check out information on our website or join us at our monthly Governing Body meetings or HealthVoice meetings, where issues such as this and more are discussed in an informed, constructive but challenging way.