You may not know this, but all our projects sit alongside e-RS written advice. Why? Because if you give GPs a choice of telephone or written advice, they will ask for advice far more often than if they only had one option. As it happens, the factors that make a Consultant Connect project a success are the same for e-RS. In fact, there are 2 golden rules for success:
1. GPs (and nurses and paramedics) should use the service a lot
To make the clinicians want to use the service, there are two conditions that have to be satisfied:
b. The “asker” is going to find out something that they do not already know – either “what should I do with my patient?” or “where should I send them?” This means making sure that the right type of clinician is responding to the request – for example, a sufficiently senior specialist or a clinical navigator.
In addition to these conditions, explicitly including advice & guidance in the pathway for certain specialties / conditions is a good strategy for reinforcing the value of the high quality advice that your asking clinicians will receive.
2. The responding clinicians need to answer
This may sound obvious, but no amount of encouraging GPs and paramedics to use advice & guidance can overcome an unreliable service. If your calls and written requests get answered reliably, though, you are setup for success. See rule 1 above!
For Consultant Connect, ensuring calls get answered is a large part of our day job. We make sure there are enough specialists on the rota, so that if one or more are unavailable to take a call, there are others backing them up. We make sure that teams are engaged, so that this is how they want to work and we feed back performance data regularly. We also survey callers – there is nothing like good GP feedback to fire up a specialty team.
With e-RS the challenge is slightly different – although clinicians don’t have to respond immediately, they do have to respond in a timely fashion. Long, unpredictable response times mean that the GP is not certain they will receive the advice when they need it, which means they won’t ask for it in the first place. The 48-hour response time mandated in 2018 by CQUIN seems to be the reasonable limit, and we encourage areas to try and hit that.
Adhering to the 2 rules above is a big challenge. If you achieve them, though, they will guarantee the success of your Advice & Guidance project, whether it’s e-RS written advice, Consultant Connect telephone advice or both. The impact on patient care and system efficiency is worth the effort.