3 things patients get out of Enhanced Advice & Guidance

Published: 28th August 2019

We are very used to talking to NHS commissioners about the “value” Consultant Connect provides in terms of reduced waiting lists, managing patient demand and cost savings from unnecessary hospital appointments being avoided.

However, an important element that can be overlooked is the value that Enhanced Advice & Guidance provides to patients. Our experience is that patients benefit profoundly in 3 areas when clinicians use Enhanced Advice & Guidance:

1. Immediate reassurance, avoidance of stress or worry

When a patient is unwell, the stress for them and their family of waiting to find out what is wrong with them can be very uncomfortable. The use of the Consultant Connect App to make calls or get Photo Advice & Guidance result in the patient being reassured about their condition immediately and, if appropriate, a care plan for that patient being agreed between the clinicians. 

For example, the following comments are from clinicians using Consultant Connect:

“A patient was advised to see me by another health professional who had noticed a change in one of the patient’s moles. I would have referred the patient to a dermatology clinic had it not been for A&G – possibly even on the fast-track suspected cancer pathway. Not only did this Advice & Guidance service give me the confidence to seek advice, but once I had received a reply from a dermatologist, it also gave me the confidence to reassure my patient. This avoided further anxiety for my patient as well as a referral.” Dr Nathan Francis, GP at Wareham Surgery, Dorset CCG. Click here to read the full case study.

“The last time I held the phone, when I took the third call in two hours I realised that this was the third person who wasn’t coming into hospital. That’s a real result.” Dr Ron Cook, Emergency Medicine Consultant, Ninewells, NHS Tayside Health Board. Click here to read the full case study.

“I constantly use Consultant Connect for advice about patient care. It has avoided unnecessary referrals.” This GP also mentions that “consultants have taken personal responsibility to fast-track any OPD (Outpatient) referrals and have arranged further investigations.”  Dr Tatavarthi, GP at St James Surgery, North East Essex CCG. Click here to read the full case study.

 

2. Avoidance of costs and disruption through unnecessary hospital visits

For many patients, a trip to hospital is more than a mere inconvenience. Transport costs, missed work, childcare arrangements and expensive car parking can have a real financial impact. The impact is increased if family members or other carers are needed to accompany the patient, increasing costs significantly.

Consultant Connect helps clinicians ensure that a patient will only make a trip to hospital if it’s necessary – for 68% of calls to Consultant Connect, the patient avoids hospital.

A paramedic used Phone Advice & Guidance to speak to an A&E consultant about a patient experiencing what had “the potential of a stroke mimic.” Immediate Phone Advice & Guidance gave both the paramedic and the A&E Consultant the confidence that the best pathway for the patient would be to be referred to their local GP rather than needing to undertake a journey to hospital. “The patient was happy that the outcome meant a local appointment with their GP as opposed to an 80-mile round trip to hospital.” Michael Muir, Clinical Stroke Lead and paramedic at the Scottish Ambulance Service in NHS Tayside Health Board. Click here to read the full case study.

“It’s a good way for them [consultants] to keep up their regular practice of clinical advice – in addition to the benefits it brings to patients and their local departments by helping to avoid unnecessary referrals.” Dr Manmit Kaur, Consultant Haematologist at Luton and Dunstable University Hospitals and a consultant on our National Consultant Network. Click here to read the full case study. 

A consultant received a call about an elderly patient, living on her own at home. She was known to have Chronic obstructive pulmonary disease, but had recently become more breathless. “We arranged an urgent Outpatient Clinic appointment, which she attended. We were able to assess her, with access to her medical records and previous investigations. Blood tests, an ECG and lying and standing Blood Pressure were checked and advice with regards to changes to her medication was given. We were able to liaise with other services involved in her care. This enabled the patient to get the assessment and support she needed without an emergency admission.”  Dr Catherine Barnes, Consultant Geriatrician, City Hospitals Sunderland NHS Foundation Trust, NHS Sunderland CCG. Click here to read the full case study.

3. Right care, faster

For many patients, an Advice & Guidance request will end with them receiving the right care from their GP there and then. For some patients, though, a trip to hospital is necessary and the patient will know that they are being referred to the correct specialist first time. 

Often, the GP-consultant conversation will result in a patient getting swift access to diagnostics.

“I saw a baby who was relatively well. He had a slight cold but the mother was worried. The examination was largely uninformative apart from an oxygen saturation of 82%. I tried different oxymeters but the sats were still low. I decided to discuss my findings with a paediatrician who immediately told me to send the child in! The child ended up in hospital for four days and was treating for the infection on site. The point is, apart from the low sats, the baby was as good as normal. Using Phone Advice & Guidance that day was crucial. If I hadn’t had the conversation with the specialist, it’s very likely that the baby would have ended up as a 999 all from home later.”  Dr Margaret Kalilani-Themuka, GP at Brooklands Health Centre, Milton Keynes CCG. Click here to read the full case study.

“My patient was facing delay to a complex gynae surgery decision. This was because the consultant was off work long term. The patient was very anxious the delay would make surgery harder and less likely to be successful. She had been ‘primed’ with a hormonal injection and anticipated a scan to assess changes and to help plan surgery. The gynaecologist understood the situation was complex and time critical and needed to make a speedy clinical assessment in the absence of the colleague. They offered to get the patient re-assessed on the 2-week pathway. The patient was relieved by this and It felt better that the responsibility was lifted off me.” Dr Peter Gregory, GP at The Surgery, South Warwickshire CCG. Click here to read the full case study.

Dr Anwar’s patient was a child with an itchy body rash and a history of eczema. As Dr Anwar was “unsure if this rash was eczema or something else,” she used Photo Advice & Guidance via the Consultant Connect App to take clinical pictures of her patient. These pictures were shared immediately with the Dermatology Team at Guy’s and St Thomas’ NHS Foundation Trust by clicking the ‘share a photo’ option on the app. Click here to read the full case study.

More information

For more examples about how patients benefit from clinicians using Enhanced Advice & Guidance visit our Patient Experiences webpage.

If you would like to find out how patients in your area could benefit from Enhanced Advice & Guidance, please contact us on 01865 261467 or hello@consultantconnect.org.uk

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