Consultant case study: Emergency Medicine

Dr Julie Ronald is the Clinical Lead for Emergency Medicine at Ninewells Hospital in NHS Tayside. The immediate Phone Advice & Guidance service, provided by Consultant Connect, has been running in this area since September 2018. Consultants at the hospital answer calls from local GPs and Junior Doctors as well as from ambulance, MIU, community hospital and prison health teams. The service is used for Advice & Guidance as well as to streamline the patient discharge and admission process.

One of the main strengths of the Phone Advice & Guidance service in Tayside is that Junior Doctors working in the Emergency Department can speak to their senior consultant colleagues before admitting or discharging a patient. Dr Ronald writes that this prevents “inappropriate admissions and, importantly, inappropriate discharges.” By streamlining the process in this way, doctors at the hospital provide a “safer discharge process” whilst also ensuring that NHS resources are correctly allocated to those who most need them. This improves patient care and reduces strain on the department.

Consultants also provide more general advice to Junior Doctors via Consultant Connect, covering aspects such as “how to manage a patient, remote review of X-rays and which specialty a patient should be referred to.” Dr Ronald comments that Junior Doctors “are able to do all of this with the knowledge that calls are recorded, so if ever required, we are able to identify and interrogate calls via the Consultant Connect system.”

Another benefit of the Phone Advice & Guidance service is that GPs and Paramedics can immediately contact local consultants. Consultants determine whether it is necessary for the patient to be seen in the Emergency Department or not. This improves the patient experience and reduces A&E waiting times as consultants can “get the right patient to the right place at the right time.”

For example, Dr Ronald and other members of her team often “suggest alternative outcomes or services that may be more appropriate for the patients than coming to an Emergency Department.” This is especially useful for “frail elderly care-home patients, where alternative pathways of care have been arranged.” In addition, as call answer times are much shorter than calling through the switchboard, there are more “incoming calls from Primary Care” which increases hospital efficiency as consultants decide on the most appropriate destination or outcome for the patient – bypassing A&E.

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