The Leeds Teaching Hospitals NHS Trust

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New electronic referral process sees 17,000 fewer first outpatient appointment cancellations in Leeds

Wednesday 25th July 2018

As part of the National NHS England Initiative to achieve “Paper Switch Off” by October 2018, Leeds Teaching Hospitals and GPs in the Leeds area have developed an Electronic Referral and Triage process from GPs into hospital. The work started in 2016 and has already resulted in 17,000 fewer cancellations of first outpatient appointments within the Leeds Teaching Hospitals NHS Trust.

Leeds Teaching Hospitals is ahead of the NHS England deadline and has adopted a process that allows for all GP referrals to be received by the national e-referral system (eRS). The electronic triage process allows the Trust to:

  • Capture the diagnosis earlier
  • Remove unnecessary appointments
  • Champion patient choice through discussing availability before an appointment is made.

The concept of receiving referrals electronically may not be new, but the Trust has improved the Electronic Referral Process even further with One Process and One Queue, to promote the “Right Patient in the Right Clinic, First Time”.

Previously a patient could be referred into hospital by fax, letter, phone call or email. With so many options there was a high level of ineffectiveness and risk with paper referrals not being seen in a timely manner. This meant that patients were not getting the right appointment first time, whether that was a convenient date or time or even having to have subsequent referrals to specialist team members within the same department.

The electronic process allows the referrals to be tracked every step of the way, and be sent directly to the consultant teams who can sort and triage the referrals appropriately. This consultant led triage allows for the identification and decision of experts to find the best option for that patient. It may be that the patient can be given advice and guidance and be kept under the care of the community team at home, or the patient would benefit from being seen earlier within the hospital setting.

When the appointment booking takes place the patient is contacted by phone. The purpose of this phone call is an opportunity to explain the next steps in the patient’s pathway journey, establishing patient availability and any additional needs or requirements (interpreters, access assistance) before the patient visits the hospital. The process that Leeds Teaching Hospitals is using has seen a range of improvements including reduced waiting times, a decline in unnecessary appointments, and the reduction in first appointment cancellations by 17,000 slots as the right patient is in the right clinic, first time.

Dr Geoff Hall, chief clinical information officer at Leeds Teaching Hospitals said “Digital technology has a key role to play in improving efficiencies within the hospital whilst continuing to improve the excellent care we provide to our patients.  Improving communications between the hospital and providers of care at home is vital to supporting the patients we look after.  The teams within the hospital and GP practices have worked very hard and collaboratively to achieve this goal and they all deserve a big thank you.”  

Alastair Cartwright, Director of Informatics NHS Leeds Clinical Commissioning Group commented, “Leeds aspires to be the best city to grow up in, the best city to grow old in and the best city for health and wellbeing.  Technology is here to support this vision by providing timely information to care professionals to support the care of patients whether they are at home, in a community setting or in hospital. This initiative forms part of our Leeds health and wellbeing plan to optimise hospital services. We are achieving our goals a step at a time to meet the national directive of paper switch off.”