In April 2021, NHS England and NHS Improvement published their ‘Elective Recovery – Accelerator Systems’ Proposal. The programme was introduced ‘to enable systems who can identify and develop innovative and transformative approaches to restore activity to 120% by the end of July.’ The regional selection was completed by 26th April.
The selection of Accelerator Systems was based on ‘capability’ and ‘desired characteristics’ – basically areas with the right leadership who’ve shown they can recover well and be a good role model were chosen. Interestingly, Consultant Connect had already been working with 8 out of the 12 selected Accelerator Systems (to deliver rapid Advice & Guidance services).
In this article, we share how successful ‘Accelerator Systems’ are using Consultant Connect to restore activity.
Referral triage
Like most areas, this NHS area had built up large backlogs of elective referrals due to the pandemic. In spring 2021 as services re-opened, the CCG decided that it wanted to re-prioritise ‘stranded’ referrals to make sure that most urgent cases were seen first, that the right diagnostics were initiated where needed and that patients were returned to primary care with a management plan (where clinically safe to do so).
The ICB used Accelerator Systems funding to ‘pilot’ Consultant Connect’s referral triage service for 1,000 referrals. The local provider was approached to see which specialties would benefit most and where pressure was highest.
Cardiology was selected to go first. Consultant Connect set up briefing meetings between the trust’s clinical lead and the ‘virtual’ NHS consultant delivering the triage. The meeting was intended to make sure that the consultant triaging was aware of local protocols and availabilities, e.g. of diagnostics in the community. Using an NHS consultant from Consultant Connect’s National Consultant Network to deliver triage meant that the local trust consultants could focus on seeing patients.
Expanding an existing Telephone Advice & Guidance pilot to cover an entire ICS
One area ran a Consultant Connect Telephone and Messaging Advice & Guidance pilot which initially launched in March 2020. The uptake amongst clinicians was extremely fast, with more than 60% of them using the service only one month into the pilot. A second locality followed two months later. At 10 months, data showed that over 3,500 referrals had been avoided since launching across both localities. The ICB calculated that around 10,000 referrals could be avoided per year if the service was applied across their future ICS scope.
The ICB together with its local providers developed a business case to cover the rollout to its entire Primary Care population and to bring on all providers in their area (4 acute trusts and 2 mental health providers). It applied for funds from its COVID Recovery Accelerator Programme.
Dermatology/ Dermatoscopes
As the landscape for face-to-face appointments has drastically changed over the last year, dermatology has been particularly affected. The need to see a rash, or inspect a lesion is crucial to effectively triaging dermatology referrals. Fortunately, over the last few years, teledermatology has become well-practised and is now seen as a safe and reliable pathway to ensure patients are reviewed without the need for an initial hospital appointment in a timely manner.
ICBs we work with have been using Accelerator or Cancer Alliance funding to capitalise on both remote, consultant-led Advice and Guidance, and 2ww teledermatology pathways.
The Cancer Alliance specifically has been further funding the purchase of Dermatoscopes to enable and better equip clinicians to see patients with lesions and rashes. We are also working with areas to offer access to ‘virtual’ NHS consultants from our National Consultant Network to help support areas where local capacity issues mean Advice & Guidance cannot be provided locally – ensuring as much as 80% of referrals, that would otherwise have been referred to hospital, are efficiently managed and kept within primary care by NHS Consultant Dermatologists.
If you have any questions or would like to find out how we can help your NHS area, please email us: hello@consultantconnect.org.uk or call 01865 261467.
