Two years after the launch of our initial referral triage pilot triaging a backlog of over 1,600 neurology referrals in an NHS trust, the project quickly evolved as the trust faced ongoing clinical capacity challenges across several specialties while also seeing high volumes of new-in referrals and new-in e-RS Advice & Guidance (A&G) requests coming in from local GPs.
NHS consultants on our National Consultant Network (NCN) acting as ‘virtual’ locums were brought in to support by remotely reviewing:
- waiting list backlogs
- new referrals coming through the front door
- new incoming A&G requests on e-RS
- follow up lists
An analysis of the neurology activity shows the service’s long-term impact in reducing waiting lists. Less than 5% of patients initially returned to their GPs with a management plan subsequently needed an outpatient appointment.
Neurology Impact | From backlog to new-in referrals, A&G and follow-up list validation
An initial pilot was launched in November 2022 to review a backlog of 1,627 neurology long waiters:
The NHS consultant on the NCN reviewed the long waiters, ensuring patients were on the right pathway, identifying those who needed to be prioritised to be seen whilst also sharing recommendations for patients who could be cared for in primary care with management plans:
- 27% of referrals were identified as suitable to return to Primary Care with management plans,
- 10% were redirected to another service in the trust
- The remaining 63% of referrals were directed to the right place, first time and prioritised appropriately based on the urgency of the required follow-up appointment (including 39% accepted for routine appointments and 3% upgraded to urgent 2WW service)
In May 2023, the project expanded to cover all new-in neurology e-RS A&G queries and new-in referrals:
- 1,906 e-RS A&G queries were reviewed with 85% of these avoiding an unnecessary referral. The average turnaround time of 1 working day meant patients were triaged promptly prior to an unnecessary referral being initiated.
- A further 4,316 new-in neurology referrals were triaged through the service, resulting 31% of referrals being removed from the waiting list and returned to GPs with management plans.
In September 2023, the NCN were brought in to support the Trust with validating neurology follow up lists:
- 1,065 cases were reviewed, with data showing that 30% were able to be discharged in full, 23% were discharged to a PIFU pathway, and the remaining were prioritised appropriately based on the urgency of the required follow-up appointment.
Specialty expansion | ENT, Nephrology and Cardiology
The success in neurology didn’t go unnoticed at the trust, and specialties facing similar clinical capacity challenges also brought in the NCN for temporary support:
- In October 2023, 3,443 ENT referrals were clinically triaged through the service, safely reducing the ENT waiting list by 19% and returning patients to their GP with management plans.
- In November 2023, the NCN reviewed 145 Nephrology e-RS A&G queries, 72% of which avoided unnecessary referrals.
- In January 2024, 544 cardiology follow ups were validated through the service, with 63% of patients discharged in full and 1% discharged to PIFU pathways.
*Data from November 2022 – November 2024
For more information, get in touch:
If you have any questions or want to find out more about how our Referral Triage service could help your NHS area, email: hello@consultantconnect.org.uk or call us: 01865 261 467.
Related materials:
- What We Do: Referral Triage and Validation
- What We Do: National Consultant Network
- In the press: Health tech cuts neurology waiting lists by more than half in fewer than two months
- Three ways to relieve pressures on hospital teams
- The benefits of Referral Triage
- FAQs – Referral Triage and Clinical Validation for the NHS
