‘The service is invaluable; our practice would be missing a limb without it, and I always include Consultant Connect as part of my induction with new staff members.’
Clinicians in Hertfordshire and West Essex (HWE) ICB have had access to Enhanced Advice & Guidance via Consultant Connect since 2021, providing them with secure, rapid support from NHS specialists via telephone, photo, and messaging.
HWE 12-month stats*:
More than 20 telephone specialties available | 9 messaging specialties available | 90% of calls answered the first time and within 29 seconds on average | Messages answered within one working day on average
In 2022, we spoke with local GPs, Dr Rikin Patel and Dr Yama Rasekh, to find out how the service was supporting them.
Managing bradycardia and pre-operative hyponatraemia
‘I saw a 72-year-old patient who had bradycardia, presenting with slow atrial fibrillation. The patient had a history of myocardial infarction, and, as their heart rate was at about 50, I was not sure whether they needed pacing. I used the Consultant Connect App to contact a cardiologist for advice on the patient’s ECG. They explained that the patient did not need pacing, which was reassuring as it meant that an urgent referral was not necessary. The cardiologist advised on the management of the atrial fibrillation, which we started in the community.
‘On another occasion, I saw an elderly patient who was awaiting a hip replacement. The operation was cancelled by the anaesthetist because the patient’s sodium level was low, and they were slightly anaemic. I carried out initial investigations but couldn’t find a cause. I used Telephone Advice & Guidance to speak to an elderly care consultant, who explained that anaemia is not a contraindication and that the patient could be transfused. I arranged further investigations for the cause of the low sodium level or hypernatremia, which allowed me to refer the patient back to orthopaedics for their operation. Getting this type of advice quickly improved the patient’s care. Without the service, it may have taken three months for them to see a consultant, and by that time, the patient could have been presenting with new clinical conditions. Using the service was a good experience for myself and the patient.’
– Dr Yama Rasekh.
Interpreting unclear ECG results and international stent medication
‘I saw a young adult patient who presented with atypical chest pain. I carried out an ECG, showing some unexpected and unexplained features. I wanted to discuss the results with a cardiologist, so I used Telephone Advice & Guidance via Consultant Connect. The cardiologist reviewed the ECG and advised that the patient needed to be referred to the outpatient department for further assessment.
‘On a separate occasion, I saw an elderly patient who had stents fitted abroad, and their medication had run out. The patient had had two previous myocardial infarctions and reported 4-5 stents being present, but all medical notes provided were not in English. Due to the procedures being carried out abroad and the ongoing medication advice given to the patient not matching the local NHS equivalents, I was uncertain of the next steps. I used Consultant Connect to speak with a cardiologist, and together, we worked out what medication the patient needed to stay safe in primary care whilst awaiting their outpatient appointment.’
– Dr Rikin Patel.
More recently, we caught up with Dr Rikin Patel to find out how the service has changed over the years and its impact on patient care:
‘Consultant Connect is now an integrated and core part of my practice; I’d be stuck if the service was unavailable. It’s so easy to access on-demand; the app itself and the specialists are very responsive, and I can resolve what I need to in the moment. The service is invaluable; our practice would be missing a limb without it, and I always include Consultant Connect as part of my induction with new staff members. There’s the added bonus that Consultant Connect activity is recognised under the Enhanced Specification scheme, which is hugely helpful. It’s super easy to use and the interface is intuitive.’
What are your most used specialties and why?
‘Specialties that include lab-based results are always useful to have access to when it comes to interpretation. If biochemistry or thyroid function results come back that are out of the ordinary, it’s helpful to discuss ideas with the relevant specialist. Additionally, elective care specialties with long wait times are also paramount. For example, locally, patients with hyperthyroidism can be waiting around 18 months to see an endocrinologist, so I’m happy to have a conversation with the specialist and start treatment in the interim. Accessing specialist advice in this way helps with finding a happy medium that serves the patient’s needs without unduly burdening primary care. GPs often already know what needs to happen, but because a lot of the patients require specialist drugs, a consultant needs to sign off on the management. It’s a quick phone call, the specialist provides the plan, and then I can add the summary to the patient’s notes and bridge the gap between the initial referral and the first outpatient appointment, whilst trying to improve their quality of life along the way.’
Patient example
‘Some weeks ago, a patient came to see me who had recently undergone a urological procedure but was experiencing issues with their stent. The patient was not managing the expected side effects and had tried a few remedies recommended by the urology team, but with little improvement. The patient didn’t have a follow-up with the urologist for a few months and came to see me in the interim. With the patient present, I used Consultant Connect to call a consultant urologist and explain what the patient had tried and ask what could be done before his appointment. Without that direct, same-day input and alternative medication suggestion, I wouldn’t have been able to navigate that specialist management on my own. Had Consultant Connect not been available, I would’ve suggested that the patient contact his consultant’s secretary to expedite the appointment or at least let them know that he was struggling. Instead, I was able to formulate a plan, prescribe a treatment, and, ultimately, reassure the patient and alleviate his symptoms.’
* Stats correct as of October 2025.
