Telephone Advice & Guidance in Hertfordshire and West Essex

We spoke with two GPs in Hertfordshire and West Essex to find out how Telephone Advice & Guidance provided by Consultant Connects helps them ensure the best patient care.
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‘it’s quick, and as GPs, we sometimes need that rapid advice.’

Telephone Advice & Guidance in Hertfordshire and West Essex

In October 2021, Telephone Advice & Guidance via Consultant Connect was launched in NHS Hertfordshire and West Essex ICB. Since then, over 60% of GP surgeries and more than 90 Primary Care clinicians have used the service. On average, calls are connected in just 47 seconds, providing clinicians with rapid advice from specialist teams.

 

To date, 60% of calls placed via the service, where an outcome was left, resulted in patients avoiding an unnecessary trip to hospital*. When patients have needed conveyance to hospital, the service has enabled their healthcare professional to confirm the most appropriate pathway before making the referral.

 

* Data correct as of January 2022.

 

We spoke with GPs Dr Rikin Patel and Dr Yama Rasekh to find out how access to the service helps them to provide the best patient care:

‘Using Telephone Advice & Guidance provides me with peace of mind and confidence, as the decision I make has specialist input and I can quickly close a patient case once the advice from Secondary Care has been received.’

– Dr Patel.

 

‘It’s quick, and as GPs, we sometimes need that rapid advice. It’s also really easy to use. I encourage other GPs who haven’t yet used it to give it a go.’

– Dr Rasekh.

 

Patient Examples

 

Dr Rasekh

‘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. I could then 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 Patel

‘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 another 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.’

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