Terms of Reference for the advisory group for the General Practitioner Referral Review Project
1. Background
Arising from the issues relating to unreported radiology fi lms and unprocessed General Practitioner (GP) referral letters in the Adelaide and Meath Hospital incorporating the National Children’s Hospital (AMNCH), the Health Information and Quality Authority (the Authority), in collaboration with the Irish College of General Practitioners (ICGP) have undertaken a project assessing arrangements relating to referral of patients from GPs to acute hospital services. Referral for outpatient appointments and diagnostic investigations are in scope for the project. This project is being led by the Health Information Directorate of the Authority. The project is broken down into four stages as follows:
1.1 Background research
During the initial stage, the Authority will identify other ongoing projects with the health sector relevant to the scope of this project. The Authority will chair consultation groups with GPs and hospital representative. These consultation groups will explore existing issues in the referral processes and the drivers of these issues. The consultation groups will seek to identify best practice and other initiatives which can lead to consistent safe equitable referral interface and pathways for patients between primary care and acute hospital services. The Authority will form an advisory group of key stakeholders in this area. This stage will be completed with the fi rst meeting of the advisory group to explore the fi ndings to date and develop the methodology for the remainder of the project.
1.2. Issue Identification and Analysis
The methodology used in this stage will be dependant on the outcome of preceding stage. Options include further consultation groups, surveys or both. The methodology chosen will be infl uenced by feedback and lessons learned from the initial stage, input from the advisory group and from the ICGP.
1.3 Guidance development
Recommendations will be developed leading to consistent safer more equitable referral interface and pathways for patients between primary care and acute hospital services
1.4. Issue fi nal report
These recommendations will require approval by the Executive Team and the Board of the Authority prior to being submitted to the Minister for Health and Children. It is anticipated that the project will be completed by the end of November 2010.
The scope of the project includes:
■ review of best practice relating to referral management
■ assessment of the business processes within GP practices supporting referrals of patients to outpatient and diagnostic services
■ assessment of the business processes within the acute hospital sector supporting the managing of GP referrals to outpatient and diagnostic services
■ development of guidance in relation to the referral process. This should include
guidance on standardised patient/clinical information for referrals and guidance on the referral management process and a minimum dataset relevant to referral management
■ assessment of impact of the fi nal recommendations
■ recommendations to the Minister on methods to improve referral processes at a National level
Areas that are out of scope for the project include:
■ assessment of waiting times from referral to fi rst appointments across all hospital sites and specialties within the acute sector
■ referrals for direct access procedures
■ assessment of laboratory ordering processes
■ assessment of process supporting the referrals to private clinics or hospitals
■ assessment of referrals from GP to Accident and Emergency Departments
■ scoping of the ICT solution to support any recommendations
2. Membership of the advisory group
Initial membership of the group will include representatives from:
■ Health Information and Quality Authority (Chair)
■ Department of Health
■ Irish College of General Practitioners
■ National Cancer Control Programme
■ Health Service Executive – Corporate Planning and Corporate Performance Directorate (CPCP)
■ Representatives from specifi c projects including the National Framework for Outpatient Management and Operations, Southern Region Reconfi guration Team, OPD National Dataset
■ Healthcare Quality and Safety Directorate from the Authority
■ General Practice Information Technology Group
■ Royal College of Surgeons in Ireland
■ Royal College of Physicians of Ireland
■ Patient Representative
■ Faculty of Radiologists
In agreement with the Authority the group may co-opt representatives from other bodies if required.
3. Role of the advisory group
The role of the Advisory group is to provide advice and assistance to the Authority at key stages of the project. They will:
■ provide advice on fi ndings from the initial stage of the project and advise on methodology for subsequent stages
■ where appropriate individuals may provide specifi c input into the project from work they are undertaking that falls within the scope of the project
■ provide advice on the recommendations being developed by the Authority that will improve the quality and safety of and access to care for patients
■ provide advice on the impact of the recommendations being developed
4. Workload and deliverables
The following is the list of deliverables (subject to agreement on the Terms of Reference).
■ attendance at three/four meetings to provide input on key aspects of the project
■ agree terms of reference and work plan for the group at the initial meeting
■ provide advise to the Authority on methodology for the second stage
■ input into the development of guidance specifi c to the scope of the Authority
■ provide feedback on the fi nal recommendations and the impact of these