Roger Tweedale presentation

1. Transforming Communications
Between GPs and Consultants
(Keeping it Simple)
Roger Tweedale
18 May 2017
Consultant Connect, Oxford Centre For Innovation, New Road, Oxford OX1 1BY T: 01865 261467 E: info@consultantconnect.org.uk

2. Ensuring Patients get the Right Care at the Right Time
the NHS will take decisive steps to break down
the barriers in how care is provided between
family doctors and hospitals
NHS 5 Year Forward View
STPs are a way of bringing together GPs,
hospitals, mental health services and social care
to keep people healthier for longer and
integrate services around the patients who need
it most.
NHS Next Steps

3. The Issue – Communication Complications
GPs
Consultants
Hospital
Switchboard
E-Referral
(Choose&Book)
GP Practice
Switchboard
Referral
Management Email
Voicemail
& Call-backs

4. The Issue – GPs Getting Specialist Advice
How does a GP currently get
advice from a specialist
?

5. The Issue – Advice Option 1 - Written
Written Advice
LetterEmail E-Referral
Written requests (take time to write)
Written responses (take time to write)
Often involve clarification questions
Significant impact on pathway timing
Generally good for complex or non time-sensitive advice

6. The Issue – Advice Option 2 - Telephone
Telephone Advice
No medico-legal record
Difficult for Hospital Trusts to track activity
Different number
for each specialty
Limited / variable hours
of availability
Long waits; PA / Sec /
Voicemail message
Consultant call-back
via GP switchboard
Direct and fast
Do you have a ‘friend’?
Will they answer a call?
Specialty hotlinesCall via hospital
switchboard
‘Phone a friend’
via mobile

7. The Solution – How It Works
GP Phone
Local Consultant
Team Mobiles
Option 1 (Cardiology)
Option 2 (Diabetes)
Option 3
(Gynaecology)
Option 4 (Paediatrics)
Etc.
1. Single dial-in number for each practice
2. NHS # input
3. Calls linked to groups of consultants
4. Calls digitally recorded
5. GPs rank call outcomes
6. Activity/outcome reporting for CCGs/hospitals
Accesses advice on all specialties on offer
(only one number for a practice to remember)
For medico-legal tracking only
At end of call by selecting from keypad options
Rather than to just one consultant
(improves answering rates)
Fully encrypted medico-legal record
(makes it paperless/admin free for consultants)
Tracks the quantum of advice provided by hospital teams and its impact
(supports putting sustainable reward structures in place)
(enables easy payback assessment)

8. Top CC Specialties Nationally
1. GP calls (landline or app), chooses
specialty, inputs patient NHS no.
2. Call loops through “rota” of available
local consultants, GP put through to first
consultant to answer
Conversation is recorded and call data
tracked. Outcome of the call is ranked by
GP / consultant
How It Works Performance Feedback
70%-80%call pick-up rate
0:53av. connection time
4:06av. call duration
Volume and Coverage
10,900,000 patients covered
38 CCG areas contracted
1500 GP practices
25 specialties offered
>90%
of consultant and GP users believe that
Consultant Connect is good for healthcare in
their area
"I rang about a patient who was
severely autistic and would have
been very difficult to admit or
even get to a hospital appt. Was
able to manage at home."
"Consultant opinion saved a
referral and helped quickly put
my patient at ease with a clear
management plan."
“Excellent initiative – back to the old days
when speaking person to person made
much more sense.”
“It provides a learning opportunity - how
to manage patients better on a case by
case basis”
Rollout
6 weeks average implementation time
Elective
• Cardiology
• Diabetes / Endocrine
• Elderly Care
• Gastroenterology
• Gynaecology
• Haematology
• Paediatrics
• Urology
Urgent
• Acute Medicine
• Acute Surgery
• Ambulatory Care
• GP Liaison
20-30%
of calls to urgent specialties avoid an
unnecessary admission to A&E or direct to ward
67%
of calls to elective specialties avoid an
unnecessary referral or admission
Experience So Far
“It is a no brainer. Most GPs and Consultants
wish the same thing - efficient way to sort out a
clinical issue. Nice to have a quick chat.”
50,000+ calls p.a.

9. Real Client Examples (to 31 March 2017; anonymised)
Cardiology
Jan-16
Diabetes/Endo
Dec-15
Paediatrics
May-16
Gynaecology
Nov-15
Activity and Outcomes:
Calls Made:
Calls Answered:
Outcomes:
- Admission Avoided
- Admission Made
- Diagnostics Requested
- Referral Avoided
- Referral Made
- No Outcome Reported
Performance:
Av. Connection Time(mm:ss):
Av. Call Duration(mm:ss):
Specialty:
Service Commenced:
#
501
385
28
12
37
185
46
77
385
00:49
3:47
%
77%
9%
4%
12%
60%
15%
100%
#
526
384
16
0
51
152
99
66
384
00:43
4:26
%
73%
5%
0%
16%
48%
31%
100%
#
379
307
4
2
33
122
60
86
307
00:49
3:39
%
81%
2%
1%
15%
55%
27%
100%
#
474
379
6
13
13
155
135
57
379
01:26
3:55
%
80%
2%
4%
4%
48%
42%
100%

10. Jean Hamilton, 77, from Romiley in Stockport. Mrs Hamilton had been
suffering from low blood pressure which had led to two visits to A&E,
including an incident where she collapsed and hit her head.
Usually a patient like Mrs Hamilton would have been referred to the
hospital, which would have led to a letter and an appointment 3-4
weeks later.
Instead, Dr Woodworth used Consultant Connect and within 25
seconds he was through to consultant endocrinologist, Dr Richard
Bell.
Between the two of them they agreed that Mrs Hamilton’s medication would be adjusted and blood
tests would be carried out, with a plan for Dr Woodworth to call Dr Bell again if needed after getting the
test results.
Dr Woodworth commented that in this case, and others, the greatest value of Consultant Connect was
the speed with which he was able to give patients more tailored advice and start addressing their
symptoms.
“If I had referred Mrs Hamilton, she would have needed to attend the hospital for an appointment, with
the inconvenience of travelling and finding parking. Following this, the consultant may have written
back suggesting the same measures. Instead, with Consultant Connect, it all happened during one
appointment in primary care.”
A Patient Story – Jean Hamilton

11. What Makes It All Work?
Low cost,
high savings
Savings from avoided
unnecessary hospital
visits are a multiple of
costs
< 6 weeks
setup
Fast roll-out,
typically under 6
weeks
No hardware,
no integration
No hidden
technical spend
IG
compliant
Call recordings stored
securely for access by
GP and consultant
Inclusion in
CQUIN
Specifically cited by
NHS England in
CQUIN 2017-19
engagement draft
Proven
technology
Platform performance
optimised through
experience of many
calls, CCGs and Trusts
Attractive economics Fast simple setup
Reliable platform World-class support
Account
management
Management of your
project from setup to
launch to business-
as-usual
Reports and
data
Regular reports
available via account
managers and online
portal

12. Oxford Centre For Innovation, New Road, Oxford OX1 1BY
T: 01865 261467 E: info@consultantconnect.org.uk