Using A&G tech for shared patient care

Published: 19th May 2021
Guest article by Dr Baskar Varadarajan, Consultant diabetes and endocrinology, South Warwickshire NHS Foundation Trust.

In this article Dr Baskar shares his experience of how the Consultant Connect service has evolved over the last four years, supporting both patients and clinicians in an integrated way.

How we started

Four years ago, our Medical Director encouraged us to embrace a new Advice & Guidance (A&G) initiative; Consultant Connect. The aim was, as I understood it, for GPs to get timely advice from specialist teams during patient consultations. I saw merit in this principle because the various existing communication channels between primary and secondary care are not always that timely.

There was some initial trepidation amongst our colleagues, because while GPs can choose to call when they want, we could be seeing patients when they call. This concern was quickly resolved by our Account Manager who set up a rota system. This means if you don’t answer a call, it moves on to the next person on the rota. The service data is reassuring as it tells us that within 30 seconds one of us is answering a call, the average call length is about four minutes. Also, it’s being responsibly used by GPs.

Sometimes I am asked if this service should replace other advice and guidance routes and my answer is no. You don’t want this to be the only default route, because where there isn’t an urgency other channels are perfectly fine and worthy.

The advantage of preliminary input

We can see from the service data that the numbers of calls that we are getting to the diabetes and endocrinology team are roughly 250 per year, and we stave off half of all the calls from otherwise being a referral. A quarter these phone calls sometimes translate to becoming a referral, but where that happens these referrals have already had some preliminary input from us in terms of further diagnostics, and therefore the encounter at the first patient visit turns out to be far more productive.

Not all referrals we see will have all come through Consultant Connect, but I am interested to discover whether we are seeing a faster throughput and a better turnaround of Referral to Treatment (RTT) because of the preliminary input.

Inter-specialist connecting approach

Our Consultant Connect service started off as primary care to secondary care, but we quickly realised that it doesn’t just have to be that direction. We are embracing communication in all directions!

In addition to the phone system, we are using photo sharing and messaging.

We are finding the photo-messaging feature, PhotoSAF on the Consultant Connect App extremely useful for shared care. In fact, since 2019 we’ve recorded about 3,200 photos. About a fifth of photos, we tend to share between us, either to the community team or the OPAT team, or the inpatient team, or the community, or the vascular and orthopaedic surgeons. The whole process has made life so much easier and better for patients – to have an accurate record of what their condition looked like, rather than just describing it.

The entire transaction of me taking and sharing the photo, the vascular team seeing and adding their comment and me closing the case with a comment is recorded.  And that is then easy for my secretary to then download the photos and messages associated with the patient case and push it to our patient record portal. Our gynaecology team are now using PhotoSAF to capture clinical photography especially the pre-op to operating theatre to have a record of which lesion they are operating.

I’m excited to embrace further enhancements to the service. It’s better for patients. And, in the long run, it can help healthcare professionals work smarter.

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