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Promoting Advice & Guidance for GPs, improving access to consultant advice

by Elizabeth MacPhie | May 24, 2020 | in Rheumatology

We launched Advice & Guidance through eRS for rheumatology 12 months ago but have had very few queries sent through. 

However, during the last 2 months there has been an increase in queries from primary care.  Consultants have been more pro-active to return referrals back to primary care clinicians and advise that advice is sought through A&G.  Referrers have been receptive to this and in many instances it has negated the need for the patient to be formally referred.

GPs have also been more pro-active to contact us about patients who they are concerned about and again this has often resulted in patients being referred more appropriately, or negated the need for a referral as advice about initial management has been given promptly.

What is needed to sustain the change?

Investing time in the triage process is needed for this to be sustained.  We have been fortunate that referral numbers have been reduced and so consulatants have been able to take a more pro-active approach providing advice and redirecting referrals where appropriate.

We are keen to look at how we look to be more accessible to GPs, so GPs can access advice more promptly when questioning whether or not a patient needs to be referred. This needs careful review of job plans and time set aside to deal with queries

What is your region?

North West

edited on Jul 13, 2020 by Kyle Beacham
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Carol McCrum May 24, 2020

Hi Dr MacPhie
Your experience with your Advice and Guidance strategy is really valuable to read-
Can you add more about whether this is a good will approach or part of a commissioned service, especially if there is more take-up of the strategy and investment in dedicated responding time.
Are you triaging any referrals towards an advice and guidance strategy before appointing
Any advice for other services from your local experiences?

Many thanks for your post

Reply 0

Elizabeth MacPhie May 26, 2020

Hi Carol
A&G is included in the specification for our service and we have a KPI related to this. When we initially launched A&G 12 months ago we job planned it into consultants clinic templates, however the number of queries coming through were so small it doesn't justify the time allocated. Currently any queries are picked up by the oncall consultant for the week and we continue to monitor the volume of referrals with a view that if the workload increases we will review our job plans.

We have included a comment on new patient letters about A&G and have sent out comms to GPs through the CCG alerting them to the system going alive and what type of queries it is suitable for.

For the last couple of months we have directed a small number of referrals to A&G. But we are aware that eRS is not particularly user friendly if you return a referral with advice and it can take time for the message to filter through to the initial referrer. Understanding the system at the GPs end and how they receive notifications has been very helpful.

I'm aware that colleague in Lancaster have set up a different system for A&G allowing GPs to directly email any queries through to the team and this has been in place for some years and works very well


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Greta McLachlan Jun 12, 2020

Status labels added: Collaboration, Education, Effective Team Working, Guidance, Information Sharing, Patient Selection, Prim/Sec Integration, Referral Pathway Redesign, Telephone Advice, Horizon 1

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Greta McLachlan Jun 15, 2020

Status labels added: Prim/Sec/Com Integration, Reduced Bureaucracy, Triage, Upskilling Of Staff

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Greta McLachlan Jun 15, 2020

The idea has been progressed to the next milestone.

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Kyle Beacham Jul 13, 2020

Status labels removed: Collaboration, Education, Effective Team Working, Guidance, Information Sharing, Patient Selection, Prim/Sec Integration, Prim/Sec/Com Integration, Reduced Bureaucracy, Referral Pathway Redesign, Telephone Advice, Triage, Upskilling Of Staff

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