Our Referral Triage service has been supporting hospitals needing additional temporary capacity to validate referrals. The service uses the expertise of the NHS consultants from our National Consultant Network (NCN) and is available to work through waiting lists in bulk or back-up local clinicians (for backlogs and/or new referrals as they come in). The service can also be used for clinical validation of follow-up reviews.
All specialists available are NHS consultants and act as ‘virtual’ consultants who are working as part of a local team and are briefed to follow local protocols and pathways. Our switch-on/switch-off model means as your local capacities change, the service can be increased to cover more specialties, reduced, or turned off completely with 72 hours’ notice.
Below you’ll find answers to the questions we’ve been asked the most since we launched our Referral Triage service for the NHS.
1. Is the triage for ongoing referral assessment or for waiting lists?
It can be used for both. Due to the pandemic and the backlogs of referrals that have built up, many areas are asking us to triage their waiting list backlogs. However, our Referral Triage service is also supporting areas with new referrals as they come in, so a front-door approach.
We will assess the current triage /assessment services set up in a specialty and work out a model that adds value with the local clinical leads and service managers. The NHS consultants are also able to review and validate follow-up lists, ensuring patients are seen or discharged, including PIFU pathways, in the most appropriate way first time.
2. Which consultants deliver the triage?
We’re utilising NHS consultants from our National Consultant Network of 17 specialties.
3. How do you ensure that the consultants triage the same way as our local consultants?
Once we’ve allocated the ‘virtual’ NHS consultants doing the triage, we set up a briefing meeting between them and your local clinical lead for the respective specialty. It’s important to discuss what’s available in your area, for example in terms of diagnostics in the community, rapid access clinics etc. If certain services are unavailable, the ‘virtual’ NHS consultant will be able to advise on the best alternatives and treatments in the interim. A sample from the first few referrals in a new project will have a second review from the local team to ensure everything is being reviewed according to your trust’s preference.
4. What is the timeframe?
We have the capacity to deal with large backlogs. For example, one project reviewed 3,450 referrals in under 3 weeks. Other projects have spread out the list more, and we cover somewhere between 150-250 referrals per specialty per week.
5. What are the benefits of using this service?
- Results in a clinically validated and prioritised waiting list
- Returns referrals with a management plan to Primary Care where appropriate
- Identifies important upgrades as well as downgrades
- Directs referrals to the right service first time
- Initiates diagnostics where needed
- Follows local pathways
- Communicates all results via e-RS
- Charged on a per referral basis
- 100% outcome reporting
- Local consultants can use the extra capacity to focus on treating patients who do need to be seen and see them quicker
- Validates follow up lists to ensure patients are seen/discharged in the most appropriate way (F2F, virtual, discharged to PIFU etc.)
6. What are the outcomes from referral triage?
Outcomes vary by specialty.
On average, 20-30% of referrals are being returned to the GP with Advice & Guidance. Small percentages are being upgraded into urgent and 2ww and, when safe to do so, some urgent referrals are downgraded to routine. Referrals can also be rebooked into alternative specialties if there has been a mistake in identifying the correct specialty, thereby avoiding a delay in patient care.
FAQs – Referral Triage & Clinical Validation for the NHS
7. What is the feedback so far?
GPs and patients have appreciated the timely reassurance and ability to commence a treatment plan when Advice & Guidance was given. Local consultants feel reassured that waiting lists are been re-prioritised in the same way as a local consultant would do while the local team can concentrate on seeing patients who need to be seen most urgently.
8. Are some specialties more suitable than others?
We have been asked to deliver this service across a wide range of specialties. Volumes seem particularly high in paediatrics (including sub-services like paediatric orthopaedics, paediatric ENT, etc.), neurology, surgery, ENT, gynaecology, cardiology, and orthopaedics.
9. Can I test out this service for one specialty only?
Yes, we recommend that you select one of your specialties mostly impacted by backlogs. We can triage your entire waiting list of the specialty or a sample. We usually recommend a sample of at least 200 to get substantial data and feedback.
10. How are the triage results communicated and actioned?
Normally via e-RS. If a local hospital uses other systems, we can accommodate it.
11. Do we need to involve any local admin resources?
12. What is the charging model?
There’s a one-off set up fee and then a per referral charge, depending on volumes.
13. How long does it take to get started?
The key element is availability for the clinical briefing meeting. After that meeting, we usually start latest 72 hours later.
14. Do you also validate waiting lists?
Yes. The same NHS consultants triaging the waiting lists can review and validate follow-up lists. Validating these follow up lists ensures patients are seen/discharged in the most appropriate way (F2F, virtual, discharged to PIFU etc.)