‘Between October and December 2016, following the introduction of Consultant Connect, the hospital believes approximately 175 patients, at a conservative estimate, avoided admission. “This is an astonishing amount, given that this reduction occurred during winter”.’
This week, NHS Elect published a report on the ambulatory emergency care (AEC) project in Sunderland. NHS Elect shares best practice from across the NHS. Sunderland’s project consists of five strands. Consultant Connect is one of those strands.
You can download a copy of the report here: AEC Sunderland Case Study May 2017.
You can also access the document (along with the CCG project evaluation paper) on Sunderland CCG’s website.
The AEC project in Sunderland came about through the local CCG and Trust’s desire to enable patients to be treated without having to be admitted.
As Dr Tracey Lucas, Urgent and Ambulatory Care Lead for the CCG says in the report, “AEC has always been too tough a nut for us to crack… We recognise, however, that we can only avoid admitting patients if viable alternatives to admission actually exist”. By offering ambulatory provision, the healthcare system had the viable alternative to admission it needed – the challenge was to ensure that the right patients accessed it at the right time.
This is where Consultant Connect came in. Our project in Sunderland provides GPs with immediate access to telephone-based advice from local hospital consultants to support the uptake of alternative pathways, including ambulatory provision.
How the Project Works
The Consultant Connect approach was used to replace the bleep system with direct Advice & Guidance from the most senior clinician available. “Our previous audits had shown that we were more likely to avoid admissions if GPs could have a senior level clinical discussion with a consultant,” said Natalie McClary, the CCG’s Programme Lead.
Natalie said: “At first some clinicians were sceptical about Consultant Connect, especially it’s connection rates, but now there is wide scale appreciation of the service. It allows GPs to have quick clinical conversations with consultants, with the patient present in the room, about whether or not a patient needs to be admitted and enables consultants to advise on alternative courses of action if necessary”.
At the end of the initial six-month pilot (October – March 2017), the metrics show:
- 96% of local practices have used or regularly use the system
- 934 calls have been made to the system with 682 calls being answered (73%)
- Average call to connect time is one minute with a call length average of four minutes
- Average hospital avoidance is 22%. The remaining 79% of patients were sent to the right place first time and, if they were admitted, experienced a quicker admission process
Between October and December 2016, following the introduction of Consultant Connect, the hospital believes approximately 175 patients, at a conservative estimate, avoided admission. Natalie added: “This is an astonishing amount, given that this reduction occurred during winter. The figure is potentially higher when reviewing the DVT and Cellulitis pathway.”
An additional benefit of using Consultant Connect is the ability to audit call recordings. As Natalie says, “listening to the calls enables us to see how effectively GP enquiries are being dealt with and also shows us quite clearly where there are gaps in our provision. It quickly becomes apparent, for example, if a new pathway is needed. We feed this information back at our regular GP events and act upon it.”
Our comments on the project
Jonathan Patrick, CEO of Consultant Connect, commented as follows: “What has been achieved in Sunderland is incredible, and the CCG and Trust teams deserve all the credit for that. The project has distinguished itself in terms of the exceptional level of engagement from both Trust and CCG. The results are an appropriate reward for the high degree of collaboration that we have seen across the healthcare system in Sunderland”.
“Naturally, we’re delighted at the role that Consultant Connect has played in this project. To be part of 175 avoided admissions in the first three months of the project from a standing start is up there with the best results we have seen nationally. It confirms what we already know: patients benefit from improved communication between GPs and their secondary care colleagues. We look forward to growing the project in Sunderland and working with such great, committed teams at the Trust and CCG”.