NHS South East London CCG was the first of our projects to embrace ‘Enhanced Advice & Guidance’ (telephone, photo-messaging, and using the National Consultant Network to support local teams when they can’t answer the phone themselves). In this article we look at how the project started, the performance to date and share feedback from the CCG.
A tiny acorn
In 2016, a small, 4-specialty project in Greenwich feeding into Lewisham Hospital was the acorn from which the mighty South East London project grew. As the geographic footprint of the project expanded into the neighbouring boroughs of Bexley, Bromley, Lambeth, Southwark, and Lewisham, so did the ambition of management to use the technology to deliver right care, first time.
NHS South East London CCG’s local providers include Guy’s and St Thomas’ NHS Foundation Trust (GSTT), King’s College Hospital NHS Foundation Trust (KCH), Lewisham and Greenwich NHS Trust (LGT), Oxleas NHS Foundation Trust, and South London and Maudsley NHS Foundation Trust (SLaM).
6 London boroughs, 5 hospital trusts
Today primary care clinicians can access rapid Advice & Guidance from over 50 NHS specialties across Elective and Urgent Care using telephone or photo messaging. Primary care clinicians in Lambeth and Southwark have had access to Same Day Emergency Care (SDEC) a selection of Advice & Guidance lines (answered by GSTT and KCH).
For Mental Health Advice & Guidance, the project began with Greenwich GPs having access to Older Adult and Working Age Adult Mental Health advice provided by Oxleas. This has since expanded to cover GPs in Bromley. SLaM also answer calls for Adult, Older Adult, and ADHD & Autism advice from primary care clinicians in Lewisham and Lambeth. Additional Mental Health advice lines now include Perinatal advice and Adult ADHD and Autism advice.
In addition to this service, South London and Maudsley NHS Foundation Trust use Consultant Connect to enable their Mental Health clinicians to access more than 80 physical health specialisms for Advice & Guidance. More about this project.
Early tech adoption
Thanks to their desire to be early tech adopters, South East London CCG have led the way for other CCGs. In fact, the project has been the first project to:
- use Consultant Connect’s Teledermatology services – connecting Lambeth and Southwark to the team at GSTT
- utilise the National Consultant Network as a backup to existing local provision
- provide GPs with access to expert tertiary advice for Paediatrics
- connect mental health with physical health for Advice & Guidance
- utilise Consultant Connect for the LAS 111 Chest Pain pathway, with a new Headache pathway planned to follow soon
The impact on patients’ care has been outstanding. Here are the results to date*:
- 51% referrals avoided (Elective Care)
- 63% referrals avoided (Mental Health Care)
- 40% of patients treated out of hospital (Urgent Care)
*on queries where outcomes were recorded by either the primary care or secondary care clinician.
We mentioned earlier in this article that South East London CCG use the National Consultant Network (NCN) to back-up local speciality Advice & Guidance lines. But how does this work in reality? The graph below shows how this has been working in practice. The NCN team answer calls only when local capacity is stretched. This back-up has boosted answer rates and has been well received by GPs.
National Consultant Network backing up local South East London consultants:
David Reith Director of Commissioning Strategy and Clive Moss Senior Commissioning Manager at NHS South East London CCG share their feedback.
“We had long felt the benefits of Consultant Connect, but with COVID-19 it has really come into its own! We rapidly increased the number of specialties available on the service to ensure that GPs could get as much support as possible from secondary care colleagues and keep patients out of hospital wherever appropriate. The feedback that we have had from both Consultant teams and GPs has been overwhelmingly positive, with relationships between staff across the system being strengthened.”
David Reith, Director of Commissioning Strategy, NHS South East London CCG
“From a commissioner perspective, Consultant Connect has provided savings to the local healthcare system, by enabling clinicians to make joint medical decisions across different healthcare settings and as a result, avoiding unnecessary emergency department attendances or potential inpatient admissions. More importantly, it has enabled patients quick and effective access to alternative hospital and community pathways, improving their care immensely.” Clive Moss Senior Commissioning Manager, NHS South East London CCG
If you’d like to find out more about how any of these services could work in your area, please email firstname.lastname@example.org or call 01865 261467.