A Doctor Writes – Getting The Most Out Of Advice & Guidance

Published: 3rd June 2016

This is the second blog from our Clinical Lead, Dr David Griffiths

As a GP with an interest in how services run effectively, I have enjoyed thinking about the different ways in which the Consultant Connect service can improve the care patients receive, and a GP’s working life.

It is not as if talking to secondary care clinicians is unusual for GPs; we do it all the time and we all know that the outcomes of these phone calls can vary from a brief word of advice to the specialist taking over the patient’s management temporarily. Some consultants offer excellent educational support, providing advice across the broad clinical area under discussion. Deep down, we also know that the quality of the advice we receive is directly proportional to the quality of the question we ask.

I’ve been running through a series of scenarios where Consultant Connect might provide benefit. For example, a GP phoning with a clear question about how to further investigate or treat a patient’s condition, even in a complicated case, should expect a straight answer from which a management plan can be generated. There are many situations in primary care where advice on tweaking medication or how to interpret and follow on from test results can be extremely helpful.

While I appreciate that reducing unnecessary referrals is a key goal of any healthcare system, even a phone call which results in a referral could confer an advantage, perhaps ensuring that the patient will arrive at clinic with an effective work-up. Importantly, it should also be the right clinic, ensuring that the patient will be seen by the best person to manage their problem. This type of signposting is hard to measure but is undoubtedly important.

Even a discussion which seems to be of limited benefit in terms of action might have a huge impact if the GP gains the confidence to avoid referral or invasive tests, particularly for frail elderly patients. I find that the condition-specific experience and nous of a consultant can be a powerful support with these tricky ethical dilemmas.

Last week I was faced with a conundrum in terms of how to manage one of my elderly patients. In particular I was unsure of the best test for his condition. My area doesn’t have access to a Care of the Elderly service on Consultant Connect, so I had to make more than ten phone calls over three separate working days trying to get someone to answer the phone and, eventually, finding a suitable consultant to chat the case through with me.

When I finally got through it was clear that my original plan would not have worked. It would have been the right test but the patient wouldn’t have tolerated it. This phone call enabled high quality care – safer, cheaper and a better experience for the patient – but it was incredibly difficult to achieve and there was an unnecessary delay. I was certainly glad of the advice but I wish I’d had Consultant Connect available to me: to have an immediate answer would have been a massive benefit to both me and my patient.

If you would like to discuss how Consultant Connect could be implemented in your area, please call us on 01865 261467 or email info@consultantconnect.org.uk

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