‘The specialist advice we receive from the consultants gives confidence to the GP opinion, and enables us to provide patients with more authoritative input.’
Healthcare professionals in Hertfordshire and West Essex ICB have had access to Enhanced Advice & Guidance (A&G) provided by Consultant Connect since October 2021, connecting them to specialist support via telephone and photo messaging. We spoke with Dr Eric Saunderson, who returned to general practice from retirement during the Covid pandemic. Dr Saunderson now locums in multiple areas, but most recently works in East and North Hertfordshire (ENH) and likes to use Enhanced A&G via Consultant Connect to get quick access to specialist opinions, especially within dermatology.
ENH stats*:
23 Telephone A&G specialties | 8 Photo Messaging A&G specialties | Calls answered within 33 seconds, on average | Messages answered within two days, on average
Why is dermatology such a useful specialty to have access to via Consultant Connect?
‘GPs now commonly see such an array of skin ailments, and they can be difficult to diagnose, so it’s beneficial to be able to write up the patient’s history, take several photographs, and forward it to a consultant dermatologist, all via Consultant Connect. Not only is Consultant Connect helpful for diagnosis and treatment, but I also learn how to treat future patients with the same conditions from the interactions.’
What makes Consultant Connect a valuable tool in general practice?
‘The specialist advice we receive from the consultants gives confidence to the GP opinion, and enables us to provide patients with more authoritative input. Often, you see a patient you’ve never met before, you don’t know what they’re going to say, but you have a small window to compute what is troubling them. In about 80% of cases, we can pinpoint what is wrong within a minute. However, the challenge lies in the remaining 20%, where it can be difficult to determine which specialism their condition belongs to, what diagnostic interventions might be necessary, and when the right time for them to be referred would be. There are hard questions about correctly managing a patient, and what the right thing to do is for them to access a diagnosis and treatment as expeditiously as possible.
‘Personal and social factors play a huge part; how might you treat a 13-year-old with Type 1 diabetes? You’d want their insulin control to be perfect because they have a lifetime of it ahead of them, and don’t want them to have complications that would affect their quality of life. Whereas if you advise an 85-year-old with Type 1 diabetes to have perfect blood sugar levels, hypoglycaemia can cause them to fall and lead to fractures and other injuries. So a lot of general practice is about judgement, and Consultant Connect supports us with our judgement in situations when we need advice in expert areas.’
Patient example
‘Approximately four weeks ago, one of my patients, who is about 12 weeks pregnant, came to see me for what sounded like rheumatoid arthritis. She had a history of joint pain that was suggestive of an inflammatory arthritis, rather than mechanical or degenerative. She had been referred to the local rheumatologist and was due to see the specialist team in 4-5 weeks, but on this occasion, she presented with a flare, mainly affecting her hands. It was excruciating; the grip of her hands was impaired and tender on palpation of the joints. Because she was pregnant, I wasn’t sure what to recommend treatment-wise. I told her about Consultant Connect and suggested we contact the rheumatologist together. We were connected quickly, and I explained to the consultant that the patient was present and described her history. Fortuitously, he told us he was a consultant rheumatologist at the hospital where the patient had been referred. He advised that he would note her details and ensure he saw her at the upcoming appointment. In the meantime, he recommended an exact regimen of oral steroids that would be safe to commence during pregnancy. The patient was absolutely delighted that she got a consultant opinion immediately and had a treatment recommendation.
‘Had I not had Consultant Connect access, my plan B would’ve been to contact the on-call rheumatology registrar at the end of surgery, who may or may not have been able to take my call. The problem with that is the endless wait times for the phone to be answered, and there just isn’t enough time to do that within the constraints of an appointment.
‘Using Consultant Connect for A&G really is a no-brainer.’
* Correct as of July 2025.
You can download a PDF of the case study, or if you have any questions about this service, please get in touch on 01865 261467 or at hello@consultantconnect.org.uk.
