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Referral Support Service. Update and Training By Natalie Fuller and Amy Mitchell
Agenda • – • • – – • • • Overview/aims of the Referral Support Service Referrals excluded from this Process (Flow Chart) Worklists Returned referrals by the Referral Support Service (Referrer Action Required) Rejected referral by a Service Provider- Acute or Primary Care Service (Rejected Referrals) Template Related Referrals Support- Start date
Overview of the Referral Support Service The previous consultant-led Clinical Selection Service (CSS/ Godiva) which was previously based at Coventry and Warwick Hospital has changed to a GP-led Referral Support Service (RSS). The Referral Support Service is based at Christchurch House and started operating officially on 1 st April 2011. The aims of the revised service are to help: • Support GP feedback and education • Ensure patients are referred to the most appropriate clinic or service first time • Ensure patients are worked-up using the most appropriate tests and investigations Continued. . .
The aims of the revised service are to help continued… • Ensure the quality and completeness of the referral information • Ensure a consistent and fair approach to Choice • Support GP consortium involvement in developing clinical guidance, referral criteria etc • Support GP consortium involvement in service redesign • Support GP consortium in taking responsibility for commissioning services and the use of resources
Similar Service Clinical Selection Service Amy Mitchell
Similar serviceprevious service The Referral Support Service is very similar to the offered by the Clinical Selection Service (Overview) in which 39 GP Practices were involved, however within the Referral Support Service we will be; • • Supporting All Coventry GP Practices Using local GP’s to triage referrals for all Acute and Primary Care services, instead of just Gynaecology and i. MSK/ Orthopaedic referrals Receiving referrals via Choose and Book into a Clinical Assessment Service where all referrals will be reviewed by another local GP before the patient is referred for treatment, providing an audit trail Feeding back to the referring GP’s via Choose and Book (Worklist) and reports, on how their patients could be treated without the need for a referral or if further tests are required before the patient is referred/ seen
Referrals Excluded from the Referral Support Service 2 WW Referrals Coventry Drugs Team Diabetic Retinal Screening Mental health Dietetics CAMHS Occupational health/equipment Learning Difficulties Wound clinic Coventry City Councils Services Jaundice Clinic Social Services Palliative care TIA Acute Coventry Alcohol Service (Swanswell) Rapid Access Clinics Obstetrics/Antenatal Gulson Road Services (Paediatrics) BPAS Community Physiotherapy Back Pain Access Community Podiatry
Referral Support Service Process
GP Consultation – GP advises the patient and provides patient with RSS leaflet explaining process Process- Flow Chart for the Referral Support Service Practice add referral on Choose and Book then book fictitious appointment in relevant Referral Support Assessment Service RSS admin team log referral RSS GP reviews referral and assesses against local services, pathways, criteria and relevant national guidance. Referral returned via Ca. B to referring GP practice because: • Advice is supplied • Additional tests or investigations are required • The patient does not meet relevant referral/treatment threshold GP practice to contact patient Referral sent to Primary/Community Care provider. RSS team contact patient by letter (within 7 working days) with details of how to book an appointment Referral sent to Secondary Care provider. RSS team contact patient by letter (within 7 working days) with details of how to book an appointment
Choose and Book Process for GP Practices
Process 1. Select the ‘Referring Clinician/ Organisation’ from the combo box.
Process Continued… 2. Select Request Type ‘Appointment’ from the Request Type combo box. 3. Select the ‘Priority’ from the combo box (Routine or Urgent). 4. Use the service search options to search for Specialty and Clinic Type
Process continued… • Click on search ‘Primary Care’, which will return only Community services. Select ‘Referral Support Service- Specialty. Coventry. PCT-5 MD’ by clicking the radio button in front of that service and then selecting ‘Appointment Search’ at the bottom, right hand side of the screen.
Process continued… • Select one of the available appointments (Bottom half of the screen) by clicking the radio button. Then select ‘Book’ in the bottom right hand side.
Process continued… 7. 8. Click ‘Submit’ from the next page that is displayed. A message will appear informing you that Choose and Book is ensuring that the appointment is still available. Please Note: • If you receive a message which explains this appointment is no longer available, you will need to select another appointment time/date as someone may have selected your first appointment before you.
Process continued… • • Once the appointment is booked it will then take you to the ‘Appointment details screen’. The referral letter and any attachments need to be added in the same way as all previous Choose and Book referrals, so you will need to ‘log out’ at this stage and ensure all of the relevant information is attached.
Choose and Book Worklists
Worklists There are three reasons why you will receive feedback, from the Referral Support Service within your worklist; • If the patient could be managed more effectively or further tests are required before a referral is made for a patient, the referral will be returned to the referring GP Practice via Choose and Book with advice • The admin staff within the Referral Support Service will feedback if the referral has been sent via paper (only if the service is unavailable through Ca. B) • Referrals that fit the 2 WW criteria (Practices will be contacted via the telephone and advised) – All returned referrals can be found within your Worklist (Referrer Action Required)
Referrals returned by the Referral Support Service Click on the UBRN, where you will be able to access the clinical information supplied by the Triaging GP.
Referrals returned by the Referral Support Service Feedback will be provided back to the referring GP outside of Ca. B (Monthly and on individual cases).
Rejected referrals by a Service Provider. Acute and Primary Care service Your ‘Rejected Referrals’ worklist will still needs to maintained on a daily basis, to ensure any previous referrals are actioned. Please note: There is a possibility that a referral that has been processed by the RSS Team may be rejected by a ‘Service Provider’ (hospital or Community Provider). All Rejected Referrals will be maintained by RSS staff as these will come back into our Worklist, however you will be notified to ensure Practices are aware and are kept up to date.
Template We have worked with our local GP’s to create one template to cover all Specialties, which will be implemented within your GP system to be used when referring our patients. The template will automatically populate; – Patient name – Patient Consent- Information Governance reasons – Address – Date of birth – Telephone number – Mobile number This Template will be – NHS number developed over time for – Referring GP details each Specialty – Medication – Medical History – Last Consultation Reason for Referral needs to be completed with clear/ detailed information otherwise your referrals maybe returned to the Practice requiring more information.
Important- items to remember! 1. All UBRN’s need to have a fictitious appointment booked (NOT A REAL APPOINTMENT), into the appropriate ‘‘Referral Support Service’’ via Choose and book Please note: If a fictitious appointment is not booked we will not know that the UBRN has been raised by the Practice and it will sit on your list as unbooked and the patient will receive a reminder letter asking them to book their appointment 2. Please raise your UBRN once the referral letter is completed to allow you to attach it straight away 3. DO NOT give any paper work to the patient, as the details to book an appointment with a clinician will be sent to them by the Referral Support Service (Aim for Urgent 2 working days, Routine 80% in 3 working days and 20% in 5 working days), if treatment is required 4. All referrals will need to be sent via Choose and Book. You will no-longer need to send referrals via fax or nhs. net email (using CSS or Choose and Book addresses).
Date/ Phase The Referral Support service will be introduced in several phases. Previous; • Monday 28 th March • Monday 18 th April • Monday 9 th May • Monday 23 rd May- Phase 1 started to use the RSS Phase 2 started to use the RSS Phase 3 started to use the RSS Phase 4 started to use the RSS Additional Practices; • Friday 5 th August- Phase 5. 1 to commence sending their referrals into RSS • Friday 12 th August- Phase 5. 2 to commence sending their referrals into RSS
Support Throughout these changes in the referral processes, support is available to ALL GP Practices via the Choose and Book Team. 0300 020 0012 [email protected] net (Consortia IT Leads)