GP and consultant case study: Cardiology

Dr Davey, a Consultant in Cardiology on the National Consultant Network, answers a GP's Telephone Advice & Guidance call - preventing a possible stroke for a patient.
National Network case study: Cardiology - Consultant Connect

‘There is no doubt in my mind that it prevents unnecessary referrals. Perhaps just as importantly, it does significantly increase the quality of medicine being practised in Primary Care.’ – Dr Davey.

GP and consultant case study: Cardiology

Primary Care clinicians in Coventry and Warwickshire ICB can use the free Consultant Connect App to obtain rapid Enhanced Advice & Guidance from NHS specialists. This can be done via the safe clinical photography feature, PhotoSAF. The photos are saved in a secure cloud and automatically added to the patient’s record.

We spoke to a GP in South Warwickshire who used PhotoSAF to take photos of a patient’s ECG, which was then forwarded for specialist advice.

‘Often there may be subtle changes that we might flag as possibly significant but are uncertain without specialist review. The app allows specialist review quickly and avoids unnecessary admissions. It’s so helpful and gives you immediate reassurance that there are no concerns. It also enables appropriate management steps to be taken if any concerns are identified.’

 

Patient Example 1

‘A 62-year-old fit and well lady presented with a new breathlessness. A routine ECG conducted as part of investigations showed some slight irregularities. I was uncertain of the significance in relation to her symptoms of breathlessness, so I used Consultant Connect to take photos of the ECG and request a consultant’s review of the trace.

The cardiologist was able to reassure us that this was not a cause for concern and that no further action was required. The patient also felt reassured. Her breathlessness was monitored and subsequently settled spontaneously.’

 

We also spoke to Dr Patrick Davey, an NHS Consultant Cardiologist who answers Cardiology Advice & Guidance queries on the National Consultant Network (NCN).

‘I joined in 2018 and enjoy speaking with clinicians. There is no doubt in my mind that it prevents unnecessary referrals. Perhaps just as importantly, it does significantly increase the quality of medicine being practised in Primary Care.

It’s just so easy to do. I only take calls when I am available and it is a pleasure to speak to clinicians, and the calls never take more than few minutes.

I’ve never received inappropriate calls from clinicians, and they have always been appreciative of the reassurance.

If you’re thinking of providing Advice & Guidance, do it. It’s great fun, you get to think about clinical problems that you may not always appreciate, you talk to bright energetic clinicians, it doesn’t take long, and you get paid. What’s not to like?’

 

Patient Example 2

‘I answered a call from a GP about atrial fibrillation and general management for a patient. The GP did not feel that the patient needed anticoagulation medication, at least until all of the tests were in. I informed the GP that the patient was at a very high risk of having a stroke and whatever the tests showed, the patient still needed anticoagulation drugs and these should be started at that time.

As the tests could easily take 3-4 months, this protected the patient against a possibly devastating stroke much earlier than originally planned.

This was a good outcome and the GP was pleased with the advice. I very much enjoy providing an easy-to-access service to GPs nationwide. I believe that they find it very useful to be able to talk through the difficult cases which are worrying them with fellow professionals, without having to go through long-winded and difficult hospital switchboards. I have been really impressed with the expertise of the GPs who access the service, and how they deal with difficult clinical problems that they face, and I believe that they appreciate the discussion and advice I give.’

– Dr Patrick Davey, Consultant Cardiologist.

 

Other feedback:

‘Referral of frail, elderly patients to hospital is almost always complicated because of their comorbidities and is sometimes not in the best interests of the patient. Telephone A&G gives me immediate access to a senior specialist colleague and an immediate outcome and plan. This is of huge benefit to these patients.’

– GP in Solihull on Cardiology A&G.

 

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