In our world we often think of the costs of a referral in purely financial terms: it is the £180 or so cost set down in the national tariff for faced-to-face consultations (or £23 for non-face to face if used). However, this does not take into account many other costs that arise from a referral, such as the cost of communication in setting up the appointment, or the inconvenience and cost for the patient in travelling to the appointment.
According to a recent report by the King’s Fund (“Transforming our health care systems, Ten Priorities for commissioners, June 2015), ensuring appropriate referral activity should be a key priority for commissioners. Why is this important? Below I quote verbatim from their report:
- “GPs make more than nine million referrals to hospital for elective care each year. These then trigger an annual spend of more than £15 billion in the NHS (McKinsey 2009). As a result, control over a significant proportion of CCGs’ commissioning budget lies in the hands of their member practices.
- Referral rates to a particular specialty within a single area vary as much as ten-fold between GPs (Creed et al 1990; Ashworth et al 2002). A wide variety of factors account for this variation, clinical and non-clinical (Foot et al 2010). The available research suggests that a substantial proportion of activity is discretionary and could be avoided or redirected.
- There are also patients who need a referral but fail to receive one. For example, lack of or late referral is thought to be a key driver of poor survival rates for cancer (Department of Health 2011b).
- There is evidence to suggest that the quality of referral letters could be improved in some cases (Foot et al 2010). The absence of key information can make it difficult to triage referrals appropriately and identify the best destination for the referral (Speed and Crisp 2005).
- GPs, patients and specialists do not always share a common understanding of why a referral is being made, for example, whether it is primarily for diagnosis, investigation, treatment or reassurance (Grace and Armstrong 1986, Broomfield et al 2001, Molloy and O’Hare 2003).”
How can Consultant Connect help?
Consultant Connect delivers a whole system efficiency:
- Patients get quicker specialist advice and only attend hospital if it’s necessary
- GPs access Advice & Guidance immediately and deliver the right care for their patients first time
- Consultants and hospitals see a reduction in unnecessary referrals, reducing workload. And, because all call activity is captured, the cost of consultant time can be reimbursed
- CCGs save money by not paying for unnecessary referrals and deliver a better service for patients
- The data capture allows for the auditing of referral rates from primary care therefore providing data to improve the system as a whole