Improving referrals
Mr Amit Sinha
The Conwy and Denbighshire NHS Trust, now part of Betsi Cadwaladr Health Board, was one of the sites developing transferable solutions to help other trusts meet the Welsh government’s 26 week referral to treatment target. It was also evaluating Map of Medicine.
With audits showing inappropriate referrals for surgery running at 10-15% and patient journeys in need of improvement, knee pain was targeted as a suitable condition for a localised Map of Medicine pathway.
The role for Map of Medicine
The audit showed greater standardisation of care and earlier multidisciplinary intervention were needed. At the same time, knowledge of knee pain amongst junior doctors, locums and primary carers needed expanding.
Mr Amit Sinha & Mrs Debbie Doig-Evans: Knee Pain Pathway in Conwy & Denbighshire (6:02)
Map of Medicine was used to improve communication between primary and secondary care, reduce care variations, reduce referrals and improve their quality, while increasing outpatient capacity. It was also used to avoid unnecessary reviews by ensuring more appropriate discharges to primary care by junior doctors.
Milestones
- Assembling a multi-disciplinary team for the localisation process
- Working virtually to construct the Pathway and convening expert panel meetings for further development.
Challenges
- Winning acceptance and usage in primary care and specifically overcoming GPs’ fear of increased workload. This involved demonstrating that the Pathway actually reduces time spent managing patients ‘bounced’ back from secondary care.
Results
- Key outcomes are being audited across a number of GP practices.
Measures include the number of GPs using the Pathway and the impact of that on referral patterns. These are being cross checked by auditing pre-referral assessments and the conversion rate to surgery.
Pending results, the project team is confident that usage has increased, improving the quality of referrals, reducing unnecessary consultations and cutting patient waiting times.