This document discusses improving communication between GPs and hospital consultants through a service called Consultant Connect. It provides concise summaries of key points:
1. Consultant Connect allows GPs to get quick specialist medical advice from hospital consultants through a single dial-in phone number, digitally recording the calls for tracking and reporting.
2. The service has proven popular with over 50,000 calls annually covering 10.9 million patients across 38 NHS areas. On average, calls are answered within 54 seconds and last over 4 minutes.
3. Studies show the service avoids around 20-30% of unnecessary admissions to A&E or hospitals and 67% of unnecessary referrals for elective specialties like cardiology
Building the Health Workforce as We Transform the Delivery System, presented by Mary D. Naylor, PhD, RN, Marian S. Ware Professor in Gerontology, University of Pennsylvania School of Nursing
Building the Health Workforce as We Transform the Delivery System, presented by Mary D. Naylor, PhD, RN, Marian S. Ware Professor in Gerontology, University of Pennsylvania School of Nursing
For the Nuffield Trust Health Policy Summit, Stephen Shortt tells the story of a journey from multiple unconnected practices to accountable community based integrated services at scale.
Reshaping the healthcare workforce - Candace imisonNuffield Trust
For the Nuffield Trust Health Policy Summit 2016, Candace Imison talks about what steps would be necessary to develop and reshape the health care workforce.
Anticipatory Care Planning: Time To Make It Happen - Early Intervention Using The Life curve Dr Sarah Mitchell (Programme Manager - AHP National Delivery Plan)
The future of primary care and implementing workforce innovations (Wessex AHSN)Robert Varnam Coaching
Presentation at Wessex AHSN event "Lifeline for general practice" event in Southampton. Including updates about the national general practice development programme, and tips on making a success of new ways of working.
For the Nuffield Trust Health Policy Summit, Stephen Shortt tells the story of a journey from multiple unconnected practices to accountable community based integrated services at scale.
Reshaping the healthcare workforce - Candace imisonNuffield Trust
For the Nuffield Trust Health Policy Summit 2016, Candace Imison talks about what steps would be necessary to develop and reshape the health care workforce.
Anticipatory Care Planning: Time To Make It Happen - Early Intervention Using The Life curve Dr Sarah Mitchell (Programme Manager - AHP National Delivery Plan)
The future of primary care and implementing workforce innovations (Wessex AHSN)Robert Varnam Coaching
Presentation at Wessex AHSN event "Lifeline for general practice" event in Southampton. Including updates about the national general practice development programme, and tips on making a success of new ways of working.
Urgent or unplanned care leads to at least 100 million NHS calls or visits each year, which represents about one third of overall NHS activity and more than half of the costs. The urgent and emergency care review was launched by Professor Sir Bruce Keogh in January 2013 in response to concerns over rising demand for unplanned care.
Alan McDermott, Regional Director Patients and Information, NHS England
Masood Nazir, National Clinical Lead, Patient Online NHS England
Trevor Fossey, NHS England Patient Working Together Group
A workshop for the South Warwickshire GP Federation, exploring the details of the 10 High Impact Actions to release time for care, and the ways in which practices locally wish to use them.
News from the Coal Face: There’s light at the end of the tunnel. Presented by Dr Andrew Miller, General Practitioner, at HINZ 2014, 11 November 2014, 4.30pm, Marlborough Room
Being open for business: 7 day opening in Primary Care
Dr Ivan Benett - Clinical Director, Central Manchester CCG
GPwSI in Cardiology
& Care Clinical Champion for Healthier Together
Presentation from the 'NHS services open seven days a week: every day counts' event on Saturday 16 November at The Metropole Hotel, Birmingham.
This event was hosted by NHS Improving Quality and NHS England to share the views and ideas of public, patients, carers, NHS England and health and social care staff on how to improve access to services for patients across the seven day week.
More information at http://www.nhsiq.nhs.uk/improvement-programmes/acute-care/seven-day-services.aspx or #7DayServices
Acute hospitals end of life care best practiceNHSRobBenson
Delivering reliable best practice in an acute hospital setting for patients whose recovery is uncertain. Including details of the AMBER care bundle. Presentation from Anita Hayes and colleagues from England's National End of Life Care Programme as part of the Department of Health's QIPP end of life care workstream seminar series at Healthcare Innovation Expo 2011
Active signposting. Training reception staff and providing tailored information about services, to connect patients with the most appropriate source of help and advice. Featuring West Wakefield's approach. David Cowan. Social Prescribing & Care Navigation Lead , West Wakefield Health & Wellbeing.
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Anatomy and Physiology Chapter-16_Digestive-System.pptx
The Future NHS Plans: Delivering Transformation and Sustainability
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.
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
Editor's Notes
Intro – RT, Director of Consultant Connect, previously
This presentation is about the simplest of initiatives, called Consultant Connect, which just makes it easier for GPs and Hospital Consultants to make contact with each other via phone
The initiative is part of the wider objective of improving integration between clinical team as referenced in the 5yr Forward View and most likely all STPs
And it’s for good reason – when GPs and Consultants talk to each other it does seem that they are able to resolve many patient issues without patients going to hospital
And yet there have been a number of systems put in place over the last few years whose unintended consequences have been to actually push GPs and Consultants further apart
So lets talk about one of the main reasons GPs call Consultants – to get specialist advice on a patient-specific issue
Option 1 – Written advice
Well established and well used
HOWEVER:
It can take time to write and respond
Can significantly delay the patient pathway
HAVING SAID THAT:
Very good if the patient issue is not time sensitive
BUT WHAT IF:
The patient needs prompt attention (eg they are in pain or the GP is worried) and cannot wait for written advice to arrive
Then they will typically seek more immediate “Telephone Advice” – which is the second option
Also an established concept – but with GPs having to battle through switchboards or trying to remember various hotline numbers.
All we have done is turned the ‘Phone a Friend’ option into a structured Advice & Guidance system – so that ALL GPs have the option of getting advice EITHER via:
WRITING – if complex or non-time sensitive; or
PHONE – if simple or time-sensitive
Its very simple ..
Been going since June 2015
50,000 calls pa currently across 25+ ELECTIVE, URGENT and MENTAL HEALTH specialties
38 CCGs, 1500 practices, 11m patients
Connection rate 70-80% - not a 100% solution
Connection time/call duration
Really good feedback – largely about how brilliant it is to get excellent advice
Looking at a few client examples (anonymised)
Note:
Not high volumes of calls – roughly 30 odd calls per specialty per month – because GPs use the service wisely
Lots of calls avoid patients going to hospital – because GPs only call regarding cases where they don’t know quite what to do with a patient or need a bit of support
Its great to know that it generates ‘whole-system efficiencies’ but even better to know that it is making a positive difference for patients.
Here is a patient case study that Stockport CCG generated that serves as a good example.
Meet Jean Hamilton
Suffering from low blood pressure; experienced falls in the past; and had already been to A&E twice
Would normally have been sent to A&E a third time
Instead Dr Simon Woodworth called CONSULTANT CONNECT and spoke to Dr Richard Bell
Agreed immediate adjustment to medication and blood tests so SAVED the patient from having to go to hospital again
Greatest value for patient – fast advice and prompt treatment
So what makes it all work
- Financials are clear for the NHS
- It’s good technology
- BUT the bit that is critical is the account management and engagement support – getting engagement from consultants who are already overloaded with patients – making GPs aware of YET ANOTHER new initiative
If you have any questions please find me in the foyer or call our office