Primary and Secondary Care working together

Published: 12th May 2023
Our project in South London features in the Academy of Medical Royal Colleges new clinically-led report highlighting over 50 examples where local collaboration has helped to improve links between primary and secondary care.
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Alongside NHS England and the Department of Health and Social Care’s joint delivery plan for recovering access to primary care, NHS England commissioned the Academy of Medical Royal Colleges to undergo a clinically-led review exploring how primary and secondary care can work better together. The report highlights a series of recommendations and shares over 50 examples where local collaboration has helped to improve links between primary and secondary care.

We are delighted that our project in South London features on page 50 of the report, under ‘Communication’. You can read the feature here, or we have replicated it below.

Consultant Connect | South London

The challenge

The mental health team wanted to break down the rigid distinction between GPs and secondary care, in particular, the different mental health teams. They also wanted to improve patient care, reduce rejected referrals, reduce administrative burden, and improve communication and learning between general practice and mental health.

The solution

Telephone advice and guidance that enables GPs to speak to the right specialist when timely advice is needed, often removing the need for a formal referral. The initiative was set up by a consultant in her spare time, initially with some paid admin support. It started at the beginning of the COVID-19 pandemic and used ‘Consultant Connect’ as they had familiarity with the system. (Consultant Connect is widely used in over 90 healthcare areas covering over 33 million patients]. It allows GPs to call mental health consultants and get real-time advice about a patient or book them into clinic etc. It is also possible to have three-way involvement between the GP, consultant and patient together. The decision and plan is recorded in the patient records and the calls are recorded so transcripts can be obtained if needed.

The outcome

Overall the new system needs less administrative support and is less time consuming than the previous referral system, resulting in improved patient care. However, South London and Maudsley (SLAM) acknowledge that limited staffing makes it hard to spread its use into other departments and services, and getting others to see it as a workload benefit rather than a time burden is challenging. Despite these kinds of issues, the initiative has connected clinicians and GPs resulting in meaningful and rewarding two-way conversations. The calls are on average 5-10 minutes, and it is easier to triage than by paper, which means decisions can be made more quickly. As a result of the advice, more often than not, further speciality involvement is not needed. The team reviewed the outcome of the calls they received. In 40% of cases a referral was avoided and for 21% advice helped GP teams to continue care in the community. In a survey of mental health consultants on the Consultant Connect rota, more than 50% felt it was sustainable, 75% said it was a good use of time and 73% said it was beneficial to patient care. Consultants commented that they had initial concerns that they wouldn’t have capacity to answer the calls, but the reality was that it was manageable with the knowledge that other consultants are on the rota if they couldn’t answer. In general they have been free and the calls have been a welcome addition to the usual working day.

“I really enjoy talking to local GPs as they know their patients well and have direct experience of the patient. Having conversations is also so much richer than text and often so much quicker to sort out complex issues”. Mental Health Consultant


For more information:

If you would like to discuss how we can help your NHS area improve links between primary and secondary care, please email or call 01865 261467.

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