GP appointment with elderly female patient

How have innovative solutions addressed the backlog?

The Covid-19 NHS Recovery Plan calls on providers to use the digital solutions that proved successful during the pandemic to improve outpatient service delivery.

Whilst the pandemic has undoubtedly placed a huge strain on healthcare services, it has also shown how technology can better manage the demand for elective care services and improve patient experience and access to care.

Reducing hospital demand

One of the major challenges before and during the pandemic has been the number of patients waiting to be treated, with the King’s Fund recently equating the 5.7 million on the NHS elective care waiting list to the population of Denmark.

The huge and ‘unrelenting patient demand’ has proven to be unsustainable and the need to redesign service delivery has been widely accepted, particularly following the seminal report by the Royal College of Physicians which, among other findings, reported that 25% of doctors felt that between 10-20% of new patients did not need to attend an outpatient clinic at all.

Since the start of the pandemic, there have been a range of technologies implemented to make outpatient care more efficient, provide patients with greater access to speedier diagnosis and treatments, and to reduce the amount of patients attending outpatient appointments when they are not clinically necessary.

Advice and guidance services

Among the initiatives recommended in the 2022/23 priorities and operational planning guidance is the increased use of advice and guidance services to not only help reduce outpatient attendance, but also give patients quicker access to consultants and help ensure that any diagnostic tests can be carried out prior to a consultation.

In June 2020, for example, trusts in North West London implemented an advice and guidance service to enable GPs to obtain rapid access to consultant advice across all specialities. This allowed consultants to triage over 40% of requests to be treated within primary care and ensure that patients requiring an outpatient appointment are prioritised. It also enabled elective treatment to continue whilst there were restrictions on outpatient care during the pandemic.

Using this system, consultants had the ability to add attachments and instructions for administrative teams. Importantly, the integration of the system with the NHS e-Referral System (eRS) ensured that any request or referral triaged for an appointment was automatically updated on eRS.

Solutions such as this help foster closer collaboration between primary and secondary care and a better working relationship between clinicians, which forms a critical component of the NHS Long Term Plan.

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