Clinical Advice & Guidance (A&G) is a hot topic at present in the NHS. The recently-published 10 Year Plan emphasised the importance of A&G, and the Enhanced Specification released in March indicated how GP practices can benefit from its use. Our recent free panel discussion for the NHS included speakers from across primary and secondary care who shared their learnings on the vital qualities of a successful A&G project:
1. Reliable and quick
Dr Ross Cunningham, GP Trainer in Enfield, North Central London ICB (NCL), has been using Enhanced A&G provided by Consultant Connect for over five years to rapidly connect with specialists via telephone and photo messaging. He shared that a successful A&G offering must be reliable and quick, because if it isn’t functional, then it’s not practical, and clinicians will default to sending their patients to A&E:
‘At my practice, for A&G, we almost exclusively use Consultant Connect. Our local A&G offering is backed up by out-of-area NHS consultants on the National Consultant Network (NCN), and, although I can’t ask pathway-specific questions, it’s perfectly appropriate and helpful to ask them generic queries. The main question is, ‘Does this patient need to see a specialist?’. If the patient doesn’t, the consultant can provide timely advice and support, whilst avoiding a hospital referral.’
What Consultant Connect users said:
‘I can use the free Consultant Connect App to quickly get an expert opinion and then advise the patient on the next steps immediately. The rapid nature of the service means the patient’s episode of care is concluded quickly, which is a bonus. Consultant Connect gives me a straightforward way to communicate, and at the end of the discussion, you know you’re both on the same page to do what’s best for the patient.’ – Dr Fedir Marangoz, GP in Gillingham.
2. Trackable to support job planning
Dr Jyothi Nippani, National Clinical Lead and Clinical Director in South Warwickshire, added that effective A&G acts as a platform for improved communication and facilitates shared decision-making – a key component across both emergency and elective care:
‘A&G is a discussion between two colleagues with different skillsets. I like to use Consultant Connect because it’s easy for both the advice provider and seeker to access. Additionally, users’ activity is trackable, which supports more effective job planning. The more consultants available to answer queries means that clinicians in the community, ambulance service, primary care, and other hospital specialties will all benefit.’
What Consultant Connect users said:
‘We have always maintained that our bleep was busy, but it’s the NHS; everyone is busy, and it was difficult to demonstrate that objectively. We wanted to prove the busyness and have evidence of interactions. All calls made via Consultant Connect are tracked and recorded, with automatic data capture, making it easier to show quantifiable evidence of how in demand we are.’ – Dr David Beattie, Acute Paediatrics Consultant in NHS Lanarkshire.
3. Available across multiple channels
Dr Steve Cookson, NHS Consultant Cardiologist, provides A&G on the NCN to out-of-area clinicians. He cited that NICE guidance is the same nationwide and therefore providing cardiological advice to a GP in Cardiff is as straightforward as providing advice to a GP who might work locally to him. He stated the importance of clinicians being able to seek advice through channels that are preferable to them:
‘In addition to Telephone A&G, Photo Messaging A&G is really helpful for specialties like cardiology because forwarding an ECG for interpretation is much easier and safer than verbally describing it.’
What Consultant Connect users said:
‘I frequently use the Messaging Advice & Guidance service, which I choose to access via Consultant Connect in my browser because I can keep it in an open tab whenever needed. I then realised that via my browser I could also make calls for specialist advice, which is fantastic because we don’t have signal in the hospital, and our mobile phones are reliant on the Wi-Fi, which can be unpredictable.’ – Hannah Meredith, Urgent Care Practitioner in Powys Teaching Health Board.
4. Quantifiable in data reports
Keith Spratt, Head of Operational Contract Management in NCL ICB, reflected on how, since Consultant Connect’s Enhanced A&G rollout in the area five years ago, the system has been adapted to meet the needs of its users. They utilise data reports to guarantee Consultant Connect remains a platform that any healthcare professional can use for clinician-to-clinician contact, whilst ensuring patients receive care in the best place:
‘The outcomes demonstrate the effectiveness of the service as we’re finding that approximately 76% of queries avoid onward referrals. The quality of the dataset is powerful because we can see that 4% of patients have been upgraded to Urgent Suspected Cancer (USC) pathways, which supports primary care in making the right decision at the right time for their patients. Feedback from our users is extremely positive, especially newly-qualified GPs, who find it to be an excellent learning tool.’
What Consultant Connect users said:
‘The reporting function in the browser is especially useful for reviewing clinicians in a practical sense. We can isolate statistics by practice and see how many patients have been reviewed. The fact that we only need to see 25% of patients referred to us is remarkable and proves how well the system works. It’s made a difference to us, the Health Board and, most importantly, the patients, who are being seen quicker and more efficiently.’ – Nicky Jones, Specialist Optometrist in Hywel Dda University Health Board.
To find out how we can support your NHS area with A&G delivery, call us on 01865 261467 or email hello@consultantconnect.org.uk.
Related materials:
- How NCN consultants are helping to transform patient care in Medway and Swale
- The Acute Paediatrics line that has tripled Consultant Connect usage in NHS Lanarkshire
- How accessing Consultant Connect from a computer is supporting clinicians in Powys Teaching Health Board
- The Ophthalmology pathways in Hywel Dda that are securing the best patient care in the right setting
- How to get Advice & Guidance right | learnings from primary and secondary care leaders
