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.
Why NHS Tayside clinicians like this service:
- Prevents “inappropriate admissions” and facilitates discharges
- Patient experience is improved
- Increases hospital efficiency because answer times are shorter
- Calls are recorded and so can be reviewed if necessary
We work with over 60 CCGs/Health Boards, 50 Hospitals, and 2,900 GP practices. Find out how we help them:
This feature, created by HSJ in co-operation with NHS Tayside Health Board, explains why the Scottish Health Board rolled out a system that provides GPs and paramedics with immediate advice and ...
A GP in South Warwickshire CCG used Phone Advice & Guidance to get A&G from South Warwickshire NHS Foundation Trust, and gets great results for a diabetes patient.
Dr Manmit Kaur, a consultant on the National Consultant Network, answers a GP's Phone Advice & Guidance call - avoiding unnecessary referral for a patient with long history of body pain.
This feature, created by HSJ in co-operation with NHS Heywood, Middleton and Rochdale CCG and East Suffolk and North Essex Foundation Trust shares the impact of networks in supporting primary care.
For more information about how we work with commissioners, hospitals & mental health trusts to improve patient care, please get in touch.
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