How a nurse-led GP Liaison service has helped to streamline the patient journey

Published: 20th July 2021
Service Manager & Lead Nurse, Sally Shaw explains how the innovative GP Liaison service in Luton streamlines patient referrals and assessments.
 

Sally Shaw played a key role in developing an innovative model of working, to streamline the ways GPs could refer patients. Thirteen years on, Luton’s GP Liaison service – believed to be the only nurse-led service of its kind in the country – handles 750 referrals a month, covering four Clinical Commissioning Groups. You can read our in-depth interview with Sally here, in which Sally tells us about how her team are continuing to significantly improve patient care.

The service is an integral part of the Integrated Discharge Team run by Cambridgeshire Community Services NHS Trust. Sally says that “Being based at the Bedfordshire Hospitals NHS Foundation Trust but employed by a community trust is beneficial as the team have a ‘foot in both camps’ with a ‘can do and if not, why not’ attitude”.

The service launched with Consultant Connect in 2015. Prior to that, GPs had to go through the hospital switchboard to get through to the team. Consultant Connect was introduced to speed up GP waiting times, because via the switchboard GPs often had to wait for 30 minutes. Via Consultant Connect, 94% of calls are answered first-time in an average of 25 seconds by the local Nursing team.

The service, commissioned by NHS Bedfordshire, Luton and Milton Keynes CCG, provides each GP surgery with a unique Dial-In Number. This allows GPs to directly call mobile phones carried by the Nursing team. The GP Liaison service is available Monday – Friday, 8am – 6.30pm.

As mentioned above, the GP Liaison team answer over 750 calls a month. The calls are taken on behalf of the Acute Trust for general surgery including queries about appendix, pancreatitis and general medicine. The direct telephone conversations allow for real-time discussions about concerns and reasons for potential referrals. The team then decide whether the patient needs to come in, or whether another pathway such as community support is more suited.

The GP Liaison service is freeing up the time of the GPs and Primary Care clinicians because they’re not waiting on the line via the switchboard. Instead, their calls are answered rapidly, and they receive timely advice and signposting. Equally, the service frees up the time of clinicians in Secondary Care as only appropriate referrals are made. The patients under this service are receiving answers and care quickly, sometimes they are followed-up the next day. Sally tells us that “working as part of the Integrated Team with our local authority colleagues, ensures that patients can be discharged as soon as is appropriate and safe to do so”.

Streamlining the patient journey was a major factor in developing this service and this is an area that is constantly being reviewed by the CCG, community and Acute Trust colleagues. Collaborative working across all the partners has allowed the team to develop close working relationships and to be able to support each other.

The GP Liaison team also have responsibility for:

  • Adding the referred patients to the ‘on call’ take list and recording the patient details. The team will input as much information as they can for the Consultants and link in with specialist nurses, to let them know which patients are being referred to the hospital, and which patients are going back into the community, to keep continuity among the services.
  • Supporting the Acute Trust with the early detection of sepsis so that they can provide an early alert across the system. They are using the NEWS2 tool which supports assessment of sepsis risk. At the same time, they are working with ambulatory care to support the development of their criteria and pathways.

The GP Liaison team are working with the Acute Trust to develop single checking of patients. This means patients arriving at the hospital’s accident and emergency unit will be seen and assessed by one person. The process is expected to be in place soon, to help ease seasonal pressures.

The impact of COVID on the team

Find out how Sally and her team use Consultant Connect to enable working from home and the continuation of the GP Liaison service, despite the pandemic: 5 minutes with a Service Manager & Nurse Lead

The service explained in a webinar

Sally Shaw was a speaker at our recent webinar. You can listen to the webinar recording: Consultant Connect in Urgent and Emergency Care

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