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#NHSChangeChallenge

Primary/Community Assessment and Triage

32 Ideas
15 Votes
164 Comments
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Please outline key changes in patient care in Primary/Community Assessment and Triage that have taken place so far during the Coronavirus pandemic and should be locked in to the NHS during the next phase and beyond.

We’re keen to hear about changes that may relate primarily to patients, staff, behaviours and the wider health system.

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  1. Ben Wanless
    209 pts
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Horizon 3

Digital community wound management system

The Wound care Information System for Health (WISH) project for the co-development and evaluation of a digital system (WoundPad) was funded by Innovate UK in 2018. The system provides a complete management solution for wounds, incorporating image capture, video consultation, advice & guidance and referral into a single software platform. It was  making steady progress, with beta testing from December 2019 of the system operationally in the NHS, until the pandemic led community team...

8 Points
5

100% AP/FCP and Physiotherapy virtual consultations, including telephone triage and video consultations. With the joint development of rapid face to face clinics with Ortho Consultants for potential serious pathology.

This has highlighted limitations of the current triage process. Moving forward we are implementing a stratified triage process, with MDT input, utilising telephone and video consultation to enable a more effective and streamlined patient journey. Benefits of this peer review process include safe guarding patient care and development of junior staff.

0 Votes
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1

Rapid access staff physiotherapy clinic.

We have started a quick access musculoskeletal physio clinic for staff. The aim was to support staff and to maintain workforce numbers during a period of potentially high sickness levels.   Staff contact physio department directly via telephone/email.  An initial telephone/video assessment is arranged (88% within 1 week).  Telephone or face to face follow up appointments are given if needed.  Referrals can also be made for imaging or for orthopaedic review from initial assessment....

0 Votes
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0

Patient dissatisfaction at providers who don't use their electronic record

As patients experience more joined-up flows in some cases (eg from 111 to general practice to community pharmacy), they are becoming more vocal in expressing dissatisfaction with the fact that other NHS providers don't use their electronic record. We have seen some submit written complaints to hospitals and community services about the risks and waste patients observe when those organisations don't use their GP notes. It's encouraging seeing patients and carers being more assertive in...

0 Votes
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0
Horizon 2

Improved advice, guidance and triage within eRS

We have an integrated pain, rheumatology and MSK service. Historically, referrals for GP's came in via one single point of access and all were triaged by MSK staff, supported by specialist teams where necessary. In the last 2 months, we have improved the patients pathway in two ways. Firstly, by adopting the advice and guidance functionality to aid Primary Care patient management with Secondary/specialist support. Pain, Rheumatology and MSK services monitor their own advice and guidance...

6.5 Points
7
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Horizon 3

Virtual Hip and Knee Joint Pain Education Group (JPEG)

We have created a virtual joint pain education group to help encourage patients to self manage their hip or knee joint pain based on the current NICE guidelines for the management of osteoarthritis. Please see attached conference poster describing the project for further information. The group provides an initial joint pain education session delivered via the online meeting platform WebEx. Patients are then directed to work independently using the EscapePain online guided exercise...

7 Points
7
Horizon 2

Adopting a Tele-First MSK Physiotherapy Service Model

Covid-19 forced MSK physiotherapy services to adopt a virtual-first approach to clinical assessments. Multi-provider evaluation of this model identified how a service model which prioritises a telephone consultation within 2-3 weeks of referral was considered optimal for services and patients. At best a patient can be supported to self management resources and discharged with SOS, at worst a robust subjective assessment can be obtained and a patient can be stratified to the optimal onward...

6.5 Points
4

Using ER-S differently for triage

patients referrals are better signposted to the right clinic first time

0 Votes
Voting closed
0
Horizon 1

Camden MSK - developing a pragmatic clinical stratification tool to decide upon telephone, video or face to face consultation at point of triage.

Following cessation of usual out patient community MSK services due to COVID 19 pandemic, all CATS appointments were initially conducted by telephone. Video consultation came online after 3-4 weeks, but was found too complex to switch to mid conversation for most patients and clinicians, and was therefore reserved for use as a follow-up appointment after initial telephone consultation where visual assessment was deemed necessary. This therefore increased the usual demand for follow-up...

7 Points
13

Holistic Discharge to Access

There has been an integration of outpatient and community services to offer a holistic 2 week discharge to access service. Priority waiting lists have also changed and been made a little simple and conscience. All helping free up beds for those who need it, and keeping those in the community out of hospital. 

0 Votes
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