Enhanced Advice & Guidance across Wales: a GP and paramedic case study

Steven Evans, paramedic, and Dr Nakul Gupta, paediatric consultant, discuss how they use Enhanced Advice & Guidance to provide the best patient care.
5 minutes with a Paediatric Consultant - Consultant Connect

‘The service is beneficial as we can have a back-and-forth conversation, reducing the number of patients coming into our services by about a third.’ – Dr Nakul Gupta.

Enhanced Advice & Guidance across Wales: a GP and paramedic case study

Since 2020, Enhanced Advice & Guidance provided by Consultant Connect has been available to all NHS healthcare professionals across Wales, rapidly connecting them with specialists for advice via telephone, photo and messaging. Steven Evans has worked as a paramedic for the Welsh Ambulance Services NHS Trust for 36 years and uses Enhanced Advice & Guidance to provide the best care for his patients.

 

We also spoke with Dr Nakul Gupta, a Paediatric Consultant at Grange University Hospital in Aneurin Bevan University Health Board. Dr Gupta answers Advice & Guidance queries via Consultant Connect and told us about the benefits of the service.

 

Patient Examples

 

Steven Evans

‘An elderly patient had recently been discharged following ten days in hospital due to a cerebrovascular accident. Given their history, mobility, gait issues, and the fact they lived at home with their elderly spouse, who was also frail, the carer was uncomfortable managing the situation. The incident could not be escalated without an occupational therapist (OT) assessment.

 

‘I arrived at the patient’s house and used the Consultant Connect App to call the Stay Well@Home Team rapidly. Following a discussion, we received amazing support from an OT who arrived at the patient’s home an hour after contact. They carried out a full assessment at home, and, at the same time, we liaised with the care services, which resulted in continued care at home for the patient. This was very helpful and a fantastic response from the Stay Well@Home Team.

 

This was the best outcome for the patient and their spouse, as they could remain at home instead of being taken to A&E.’

 

Dr Nakul Gupta

‘I recently answered a call on the outpatient advice line. The patient was a young child who had recently moved here from a different country and had a rare metabolic disease. The child had been under follow-up in their country of origin, and the GP was wondering how best to get them a follow-up within our services. I pointed the GP and child to the relevant specialists within our Health Board who have experience dealing with rare metabolic conditions. This enabled the GP to refer the child immediately to the right place, avoiding a referral to a general paediatrician who may not have experience with this rare condition.

 

 

What Advice & Guidance lines do you provide via Consultant Connect?

‘We use Consultant Connect to offer an Acute Referrals Telephone Advice & Guidance line, which can be used when clinicians need advice on whether the paediatric patient needs to be seen in outpatients, within the urgent assessment unit, or if they can remain at home. We also provide a non-urgent Telephone Advice & Guidance line with optional messaging. This is for occasions where clinicians might be considering a referral to outpatients or require advice on what they can do in the community and avoid a referral.’ – Dr Gupta.

 

How do you find providing Advice & Guidance via Consultant Connect?

‘I find it rewarding and useful. The service is a partnership between Secondary and Primary Care, where on the acute rota, we can provide urgent advice without the patient needing to be seen on the day. This enables patients and their families to be streamlined into a more appropriate service, meaning they don’t always require a hospital visit during these challenging times.

 

‘GPs I’ve spoken to as part of the non-urgent outpatient service have found it useful to discuss their uncertainties. Together, we can work through these and find the best solution for the patient. The Messaging Advice & Guidance service is beneficial as we can have a back-and-forth conversation, reducing the number of patients coming into our outpatient services by about a third.’ – Dr Gupta.

 

What do you like about Consultant Connect?

‘One of the things I like the most is working in partnership with our Primary Care colleagues to find the best solution for the patient – at the end of the day, that’s what we’re all here for. It’s the shared decision-making to find the best way forward to manage our patients and provide the best care for patients.’ – Dr Gupta.

 

‘The Consultant Connect App gives me direct contact with GPs, Primary Percutaneous Coronary Intervention, Ambulatory Emergency Care Units, Elderly Care Units and social services. It’s been an easy tool to use, and, as a solo responder, liaising with other professional services has helped me in my day-to-day job.’ – Steven Evans.

 

What would you tell colleagues who haven’t yet used the service?

‘I would encourage colleagues to use this service, and it’s straightforward to report outcomes.’ – Steven Evans.

 

‘I would strongly encourage this service to be used. The people who have used it have found it extremely useful and helpful. We all know how difficult it can be to find the right numbers or point of contact. With Consultant Connect, it’s like a pre-programmed phone directory, and it puts you straight through. If the first person on the rota isn’t available, you’ll automatically be passed onto the next person without needing to make a separate phone call.’ – Dr Gupta.

 

Watch our video clips of Dr Gupta talking about his experience below:

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