Reducing the referral backlog for community paediatrics in Buckinghamshire

Published: 2nd February 2023
Due to a significant backlog of patients awaiting a community paediatrics appointment in Buckinghamshire, a Referral Triage project was initiated for 450 existing cases.
paediatric advice speeds up patient care in Glasgow

The backlog

Due to a significant backlog of patients awaiting a community paediatrics appointment in Buckinghamshire, a Referral Triage project was initiated for 450 existing cases. Dr Loucas Christodoulou, an out-of-area NHS Consultant Paediatrician, who is part of the National Consultant Network (NCN), was brought on board to triage the caseload and reduce the clinical risk.

Before beginning triage, Dr Christodoulou was briefed regarding the referral criteria for the community paediatrics team, so they could ensure that the patient was on the correct pathway.


‘Consultant Connect enabled clear communication with local services and pathways to ensure a prompt review for these children by the most appropriate team. They arranged meetings between the local clinical lead, the commissioners and me so that the referral criteria could be clarified.

‘Large numbers of referrals were quickly uploaded so that I could triage rapidly and more efficiently. Consultant Connect’s platform offered the ability to see all referrals promptly, revisiting where necessary and creating a resources folder for easy access to advice for similar cases.

– Dr Loucas Christodoulou, Consultant Paediatrician.


Consultant Connect supported Buckinghamshire Healthcare Trust to cast a fresh eye over referrals coming into the service and better understand the source of referrals and, consequently, their understanding of community paediatrics. It has been a pleasure to work with them so far, and I’m sure once our initial project is complete that we will find some more work for them!’

– Olivia Mosley, Service Lead for Community Paediatrics at Buckinghamshire Healthcare NHS Trust.


The results

So far, we’ve seen 42.7% of those triaged being returned to the referring clinician with thorough advice and guidance and a comprehensive patient management plan. This ensures that patients are seen or referred back in the most appropriate manner to the right service, reserving appointments for those who need them.


‘Triaging referrals for an external service, especially one as complex as community paediatrics, was challenging, but also very rewarding, both for myself as the triaging clinician and the families who were awaiting communication and support.

‘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 that 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, Consultant Paediatrician.


The remaining 57.3% of referrals have been booked into routine appointments without diagnostics with the community paediatrics team. As our service identifies upgrades in addition to downgrades, initiating diagnostics where necessary, specialist clinicians’ time is used more effectively, seeing patients who require appointments as a priority.


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