Triaging referrals has become a fundamental step for many trusts and hospitals, especially since the volume of patients waiting for consultant-led elective care is at an all-time high.
For many specialties in Secondary Care, numerous patients awaiting care on referral to treatment (RTT) pathways are now deemed long-waiters, carrying a significant clinical risk.
Our Referral Triage and Clinical Validation service uses the expertise of NHS consultants from the National Consultant Network (NCN) who work remotely as ‘virtual locums’ to triage referral backlogs in bulk and new referrals as they come in. Our NCN consultants span 17 specialties and triage and clinically validate waiting lists whilst following local protocols and pathways under the leadership of local clinical leads.
Referrals are prioritised according to urgency, and patients receive treatment plans ahead of their appointment for a large majority of cases. This results in some patients no longer requiring their appointment and better informed first appointments as treatment has commenced/diagnostics have been performed.
Benefits to patients
- Patients whose care is more urgent are identified and booked for a priority appointment with the local specialty team, receiving appointments for diagnostics beforehand where necessary.
- Full management plans from a qualified NHS specialist are provided to the referring clinician for patients referred to Primary Care.
- Patients are seen or discharged in the most appropriate manner, reserving appointments for those who need them.
- Patients are referred to the right service the first time so they can receive the correct treatment.
‘One of the key benefits of the work is that I can advise on treatment options which can be implemented for an immediate impact on the patient’s disease management. Furthermore, the initial treatment for many of these patients actually turns out to be more definitive, often removing the need for the patient to be seen in hospital. Patient lives are made better and safer. This has a huge impact on the patient’s wellbeing and productivity, as well as their health.’
Dr Rabi Nambi, NHS Dermatology Consultant who triages referrals on the NCN.
Benefits to Secondary Care
- Our process identifies upgrades in addition to downgrades, initiating diagnostics ahead of elective care appointments where necessary so that local specialists can concentrate on patients who need to be seen urgently.
- The NCN consultant(s) responsible for the triage work will be briefed in relation to what resources/local pathways and services are available in your area.
- Our Referral Triage and Clinical Validation service has the capacity to assess as many referrals as needed, meaning high volumes can be managed quickly.
- Our service comes with 100% outcome reporting, which is communicated via eRS.
Benefits to commissioners
- Our Referral Triage model can be rolled out at pace and is flexible and adaptable to fit your local needs, meaning that the system can be increased, reduced or turned off completely within 72 hours, depending on local capacity.
- Our NCN consultants can triage as many referrals as needed, helping your NHS area eliminate waits of over 65 weeks for elective care in line with the NHS priorities.
- As projects can be designed to tackle backlogs, triage referrals as they come in or validate follow-up lists, patient outcomes are improved. As a result, clinicians’ time is spent more efficiently, seeing the most urgent patients first.
‘I’m pleased with how smooth this was to set up, manage, communicate, and progress. Having weekly meetings allowed us to keep track of and provide feedback, which meant any issues were resolved straight away. The two consultants worked well within our Welsh guidance and followed local processes. Their advice and guidance back to the GPs was clear, professional, and concise.’
Ceri Wisdom, Service Delivery Manager in Hywel Dda University Health Board.
Benefits to Primary Care
- Returned referrals are attached with appropriate and comprehensive advice and guidance for the patient’s management.
- Patients deflected back to Primary Care mean that the referring GP can initiate a treatment plan in a timely manner.
‘Throughout the triaging process, I aimed to empower the referrers and families to initiate supportive measures, even if the referral was returned to the GP. Extensive advice and support resources meant many could be appropriately rejected, thus easing the waiting list. Long waiting times led to a lot of frustration and further delays. By offering extensive advice with rejected referrals, the level of knowledge to the referrer is improved, which will ultimately enhance the rate of appropriate referrals.’
Dr Loucas Christodoulou, NHS Consultant Paediatrician who triages referrals on the NCN.
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