Health Service Focus

08.06.16

Specialist advice at the touch of a button

Source: NHE May/Jun 16

Tim Ryley, director of strategic planning and governance at Stockport CCG, runs through a new service that has cut down on costs, time and red tape by quickly connecting GPs to specialist consultants during appointments.

“Imagine I’m a patient who is sat with a GP with a particular need,” Tim Ryley, Stockport CCG’s director of strategic planning and governance, tells NHE. “The GP thinks: I might need to refer you, but I’m not quite sure what to do here without some expert advice from a consultant.” 

Currently, he said, GPs would then have to write a referral letter, after which the patient would have to wait for 10, 12 or maybe even 18 weeks until being able to see a consultant. But now, with the CCG’s new innovative Consultant Connect service, this process can all be carried out in a matter of seconds. 

“GPs dial a number, get given a set of options, and click which speciality option they want. The phone then chases round each of the consultants in that speciality until one of them answers – so it rings one, and then if they don’t answer in a set period, it jumps to the next one, and so on down that list of consultants in that speciality,” Ryley said. 

“One of them then answers, you have a quick chat about the patient, get some advice, and you probably now don’t need to refer them. They don’t need to wait 12 weeks, they can leave your practice surgery with the decision and, all at the same time, the NHS is spared a fortune in outpatient clinic costs and sending notes and letters round the system.” 

Less pressure on the system 

Consultant Connect, rolled out in April to bridge the divide between both professions during patient appointments at Manchester’s Stepping Hill Hospital, has since phased out the historically difficult challenge of reaching busy hospital consultants by phone through its unique ‘rota’ system. 

“The reality is, the conversations the consultants are having are shorter than having a full outpatient clinic, so in time, it will actually release pressure from the GPs – who probably would’ve had to have two appointments, one to send the person and one to get the letter back from the consultant,” Ryley explained. 

“In the medium term, what we’ll end up with is less pressure on the system. It reduces lots of red tape and letters and things lying about, but it actually also reduces consultation time, for both GPs and consultants.”  

The service had already been used in Bristol and Essex, but Stockport is “using it and planning to use it much more aggressively and across a much wider range than most places”. 

Ryley noted that the service is currently used by four specialities, which is going up to eight, and there is a desire to roll it out across all specialities next year. 

Fitting in with devolution and the vanguard model 

Although seemingly small-scale, the £40,000 programme is a crucial element of the two major changes ongoing across Stockport: its status as a vanguard as part of Stockport Together, and its place in the wider Greater Manchester devolution. 

The first means the CCG is looking at the interface between acute hospitals and general practice, making sure people only go to a hospital when they need to. 

The second is fundamentally important in that Greater Manchester has recently taken control of its devolved £6bn health budget, meaning trusts are looking to reduce costs – something Consultant Connect “clearly does”. 

“The other thing I find important, and Greater Manchester is putting a lot of emphasis on that, is neighbourhood – your care closer to home,” said Ryley. 

“A one-stop opportunity rather than multiple appointments, therefore, absolutely fits.” 

While it’s still early days, the service has already prevented hospital referrals in 70% of recorded cases. In the first month, over two-thirds of GP practices made use of the service, and the feedback has been incredible: 75% of GPs felt it had a positive impact in their work, and a whopping 100% felt it enhanced their knowledge and improved patient care.

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