Audits carried out in SE London indicated that roughly 25% of referrals did not require secondary care level treatment and could be managed in primary care with advice, guidance and support.  The audits also found that e-RS was not always a good option for Advice & Guidance, especially when the request was more urgent or complex. 

The STP made a decision to supplement their e-RS advice service with Consultant Connect’s immediate Telephone Advice & Guidance. This gave GPs the additional option of an immediate conversation with a specialist, often during the patient consultation.

The STP also decided to use the National Consultant Network as a back-up for answering A&G calls in some specialties. This meant that, if local consultants were not able to answer a call, it was put through to a non-local NHS consultant to give them advice. This ensured answer rates were high, a fact much appreciated by GPs. 

The impact of this “enhanced” advice and guidance project has been to reduce referrals. SE London reviewed the project’s performance and impact over the year to end June 2019 and reported on it to NHS England. We publish the report below.

The STP is now continuing to expand the project to maximise its impact. Actions include:

• Wider roll out of Consultant Connect to more specialties including:

  • Physical health e.g. urology

  • Mental health

  • Medicine management

  • Urgent and emergency care

• Wider use of the National Consultant Network: this involves NHS consultants working in other parts of the country backing up local specialty lines. This back-up is already in place in some specialties, which has boosted answer rates, and has been well received by GPs. Other specialties will be similarly supported by out-of-area consultants.

• Giving specialists access to other specialists: Consultant Connect has a Consultant to Consultant function which allows specialists to contact their colleagues in other specialties that are using Consultant Connect. For example, plans are underway to give Mental Health specialists access to Physical Health specialists.

• Rolling out wider usage of PhotoSAF: PhotoSAF allows GPs to take photos in an IG compliant way, and for them to be attached to patient records, referrals and e-RS advice and guidance requests. It is also allowing GPs in SE London to share photos directly with teams of dermatologists, who are able to offer advice in only a few hours.