5 minutes…. with our Referral Backlog Triage Lead

Published: 17th March 2021
Delegates at our recent COVID Recovery webinar listened to the collective experience of three of our most senior colleagues who are working with 80 areas to help accelerate their COVID-19 recovery. We’ve edited the discussion into a weekly 3 blog article ‘5 minutes with’ series, starting with a focus on Referral Backlog Triage.

Delegates at our recent COVID Recovery webinar listened to the collective experience of three of our most senior colleagues who are working with 80 areas to help accelerate their COVID-19 recovery.

We’ve edited the discussion into a weekly 3 blog article ‘5 minutes with’ series, starting with a focus on Referral Backlog Triage.

The discussion was between our CEO Jonathan Patrick, and Kat James our Head of Customer Engagement who also manages our Referral Triage Backlog service.

We’re going to start talking about hospital waiting lists, Kat tell us how NHS areas are using our referral backlog triage service to reduce waiting lists?

“I think the latest figure that we’ve probably all seen is the 4.5 million patients on waiting lists currently, and then the second factor really driving the backlog problem is what’s anticipated over the next few months. We all know that patients saw their GP less during lockdown and last year the referral activities were down by 6 million compared to the year before.

 

The way are working with the trusts and hospitals to address the backlog problem is by delivering referral triage as a managed service, or managed project, meaning we look at which specialty is particularly challenged in their area. We then we select the local consultants that want to participate in the project, and if needed we also bring in resources from our National Consultant Network. The consultants on our National Network are all employed NHS consultants. They’ve signed up to do additional work, evening times or weekends. We’re essentially bringing NHS consultants from other areas like virtual locums to a local team, and then they triage using the Consultant Connect platform. The advantage of this is that it’s fast, and it can be done from anywhere – they can do it on their laptop, desktop, or even via their mobile phones.

 

This also means that a Trust/hospital can use the Consultant Connect platform to utilise consultants that are shielding or self-isolating and are at home. The end result is a reprioritised list, in e-RS, which then allows the local teams to work through those lists, see the most urgent cases first and work their way down. Part of the exercise is also that the triaging identifies referrals that might be better seen in another part of the hospital, in a different service, or even a tertiary unit. Another important result of it is that it identifies referrals that can safely be returned to primary care with advice and guidance. From the pilots that we’ve done, around 20 to 30% on average can go back to the GPs with a proposed management plan before they then reconsider if a referral is still needed.”

How are we able to make consultants who aren’t local aware of local pathways?

“Well, it’s important to keep in mind they’re all NHS consultants, so they do follow the national guidance in their specialty. As part of this exercise we bring them together with a local team and brief them on local protocols, any deviations from standards that they should be aware of and making them aware of things such as what’s available, i.e. instance diagnostics in the community. This helps them know what can or can’t be done in an area. Ultimately there’s no difference between if a local consultant does it, or an NCN consultant, they work together as one team.”

Are there specialties where this service works particularly well?

“We’ve worked with a broad range of the specialties that you would probably expect, so gynaecology, urology, paediatrics, ophthalmology. I think one that particularly stands out is ENT, and that’s for two reasons; one is because of the high demand, so not only has it been mentioned by literally every area that we work with, but secondly because of how efficiently it has worked. So, from the ones that we’ve done in ENT we’ve seen around 15% of referrals were returned with advice and guidance, another 15% were identified as those where otherwise the patient would have come to hospital let’s say 12 months after being referred, to then be told that there’s no surgery for that particular condition, so that obviously saves the patient appointment, and so a quicker reassurance for the patient. And then another third were redirected to other services in the Trust, or in the tertiary units, ENT has definitely been very effective.

As we’re reprioritising the e-RS referral list, we’re making sure that patients are correctly ranked in terms of the urgency, that those patients that can get the treatment that they need immediately from their GP, where it’s appropriate, can be sent back from that, and that’s obviously amazing, rather than having to wait months and months for, you know, an outpatient appointment that you don’t necessarily need.”

How easy it is to set up this service?

“It is remarkable how quickly we are able to set this up in areas. All it takes is for the Trust/Hospital to give us access to their e-RS waiting list and then we let our consultants go do their thing.”

 

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