UCLPartners bring together researchers, the NHS, industry and others to harness research and innovation for excellent patient care and a healthier population. To help support the adoption and spread of Consultant Connect they were keen to present it at their primary care innovation network meeting and show how NHS North Central London CCG are using rapid Telephone Advice & Guidance to support GPs and patients during the pandemic.
You can watch Dr Nausheen Hameed, Health Tech Advisor at UCLPartners interview Stephen Wells, Senior Programme Manager within the transformation directorate of NHS North Central London CCG on UCL Partner’s YouTube channel or read a transcript of the interview below.
Question 1: What is the technology that you implemented, and what was the problem you were trying to solve?
We implemented the Consultant Connect App, which is a mobile application, which enables GPs to make contact with a hospital clinician, a consultant in a range of specialties. The reason we did this was very much due to the impact of the COVID-19 pandemic, and the importance to enable GPs to gain quick clinical advice and guidance to manage their patients in primary care – particularly when we had such a significant reduction in outpatient appointments that were available for routine patients.
Question 2: Excellent, and how does this app work?
On the Consultant Connect App on their mobile the GP has a list of available specialties to call, either locally or on the National Consultant Network. To call a specialist for advice, the GP taps the specialty on their screen – for example cardiology. They are then prompted to input the patient’s NHS number and can then place the call. The call is then directed to a cardiologist, either in their local hospital or if they’re not available it diverts to the National Consultant Network. When the consultant answers the call, they have a conversation with the GP and provide advice and guidance. The clinical advice and guidance could be anything from discussing diagnostics, to actually making a referral, or recommendations in managing that patient in a primary care setting.
Question 3: How has this benefited patients, and the GPs using the app?
The real benefit has very much been, particularly during this first wave of COVID, putting GPs in touch with senior clinicians in the hospital, to manage their patients appropriately, and most importantly enabling them to get that timely clinical advice and guidance.
We saw the impact of the first wave of the pandemic in terms of reduced access to first outpatient appointments, and we wanted to ensure that our GPs locally had access to clinical advice and guidance. Some of the key issues were also around our local referral management support service, and again the Consultant Connect App also has the capability of using not just the telephone, but also photo messaging. Again, through the NHS electronic referral system the GP can write a message to consultants and provide additional information, from information about the patient’s condition and history, to actually sharing diagnostic reports, such as an echocardiogram or a laboratory report for example. So it’s a very useful tool with the ability to share a lot of information very quickly with specialists about patients.
Question 4: What impact has Enfield seen since the implementation of the Consultant Connect service?
We went live back in March 2020, just as the pandemic struck really, and we launched using the National Consultant Network, across 15 specialties. Since then we’ve made in excess of 2,000 telephone calls, and also in excess of 1,000 photo messages, and that in itself just shows you how our GPs use the service. We got some additional funding from NHS England and extended the service in May 2020, to GPs in Barnet. We started quite small but have now extended it to 13 specialties, and we’re now progressing the use of the service with our local acute trust. In NCL CCG we have over 300 GPs using the service.
Question 5: That’s amazing. What advice would you give someone or a CCG who was thinking of adopting this technology?
I think it’s very much looking at where you want to focus the benefit, to understand what the challenges are around clinical advice and guidance. We’ve seen nationally a lot of CCGs, as we did in North Central London CCG, develop their own policies, which are very much an email-based approach, and it often takes quite some time to get a response back from a hospital consultant. Given the other changes that happened as a result of the pandemic, and continue to be in place with general practice, the seamless application of this tool in terms of all the other digital applications, whether it’s e-consult, or other technologies that are being used to contact patients between the GP as well.
We’ve also used this technology with patients, so for dermatology for example we’ve actually developed protocols with our services and with our consultants to actually enable the patient to take an image and share that with the GP, and then through the governance that we’ve got in place in terms of information governance we can share those patient images directly through the GP practice, to the referring consultant via Consultant Connect. We very much wanted to make the whole process of seeking clinical advice and guidance much more seamless, but also much quicker. In addition to that, when you’re looking at developing this start small and then expand – that’s certainly what we’ve done, and we’re now doing a progressive piece of work to get many more specialties in place. We’ve also developed a framework, particularly with the North Middlesex University Hospital to actually measure the success of replacing our NCL CCG clinical advice and guidance, so we’re meshing the activity, the response times, we’re looking at the specialties.
One of the biggest advantages of using this system is all the information is recorded, so you can have audited reports from the system that enables GP education sessions – we’ve recently undertaken a session with our GPs in Barnet and with consultant cardiologists at the Royal Free London Hospital, to share the sort of first six or seven weeks’ worth of use of that specialty, and to provide some very good clinical feedback, but also share important messages about managing patients in terms of that specialty, and we’re doing that with many others as well.
I think another important thing is when you launch this, it’s really important to have a strong communication, and a joined-up voice between each of the hospitals, the CCG, and with the practices, and also to engage with your primary care networks, clinical directors, and really build the key messages that you want to engage, your local GPs to use this service.
Related materials and links
- Video: UCLPartners Primary Care Innovation Network – Consultant Connect
- NHS Area Case Study: Enfield project update & expansion plans
- NHS Area Case Study: Barnet – project update
- GP Case Study: Remote specialist advice – secure sharing of patient’s photos avoids hospital visit
- Webinar Recording: COVID-19, the role of Advice & Guidance in the NHS
- Webinar Recording: NHS Advice & Guidance for the “new normal”