Success of gynaecology Referral Triage and Validation project in Coventry and Warwickshire leads to additional projects for the ICB
A Referral Validation project at University Hospitals Coventry & Warwickshire was initiated in 2022 as a result of the build-up of gynaecology referrals. From over 1,000 referrals, only 56% of patients needed to remain on the waiting list, with the remainder suitable for treatment on alternative pathways.
The success of this project sparked the set-up for two further projects for gynaecology in Coventry & Warwickshire: A Referral Triage project at South Warwickshire NHS Foundation Trust (SWFT), where a backlog of 500 existing referrals was validated, and an Advice & Guidance Triage project at University Hospitals Coventry & Warwickshire, where a backlog of 500 requests for Advice & Guidance (A&G) made via e-RS was triaged.
After establishing the requirements of the project, Dr Prashant Purohit, Consultant in Obstetrics, Gynaecology and Reproductive Medicine, and Mr Eric Mutema, Consultant Obstetrician and Gynaecologist, both of whom are out-of-area NHS Consultant Gynaecologists on the National Consultant Network (NCN), were briefed and brought on board to triage referrals. The consultants were aligned with local services in the area and familiarised with the criteria for Secondary Care referrals in Coventry and Warwickshire.
One of these local services included a Primary Care Gynaecology Pathway run by GPs with an Extended Role (GPwER). This pathway is suitable for patients with particular symptoms under certain criteria and was an option when the triaging of referrals began.
‘Consultant Connect is a brilliant platform to get rapid access to specialist advice. As a consultant in charge at my own hospital to reduce outpatient referrals and follow-ups, this is a great initiative and helps both Primary and Secondary/Tertiary Care. It feels like a win/win situation for all parties and the health sector in the UK. Not to forget the high level of patient satisfaction due to rapid advice.’ – Dr Prashant Purohit, Consultant in Obstetrics, Gynaecology and Reproductive Medicine.
Both additional projects consisted of 500 existing cases each and were completed in December 2022. The Referral Triage project at SWFT resulted in 61% of referrals remaining on the outpatient waiting list. Additionally, 24% of the referrals were allocated to the Primary Care Gynaecology Pathway, and 14% were upgraded to an urgent 2WW pathway, ensuring that patients are seen or discharged in the most appropriate manner, and reserving appointments for those who need them.
‘It’s a tech revolution; an innovation that’s helpful to the NHS. This is especially true post-Covid, where there’s so much pressure with staff shortages, and we must be focused on where we use our human resources. It takes away a big chunk of NHS pressure in a reliable way where you can track and audit the outcomes.’ – Mr Eric Mutema, Consultant Obstetrician and Gynaecologist.
The outcomes of the e-RS triage showed that 59% of requests for A&G were returned to the GP with comprehensive instructions and a full patient management plan. An additional 10% of A&G requests were suitable for the Primary Care Gynaecology Pathway, and a total of 15% of A&G requests were returned to the GP with the advice to refer (4% of which were for urgent referrals).
‘I find that about a quarter of the patients who have been referred to hospital don’t need to go there – and that saves a lot of capacity. There are a small number of people sitting on the waiting list who need to be treated urgently. Getting the opportunity to review them means they get seen quicker.’ – Mr Eric Mutema, Consultant Obstetrician and Gynaecologist.
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- Referral Triage and Clinical Validation service
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- 30% – 45% of long-waiters receive initial treatments plans