Electronic Referring
- digital by default
CLN Congress – Workshop 23 October 2012
Dr Stephen Miller - Medical Director Dr Caroline Tait - Primary Care Clinical Lead Ben Gildersleve - Programme Manager
Workshop Agenda
1. What is needed from an electronic
referral/booking service of tomorrow? – what is already available today?(20 mins)
2. ‘Digital by default’– Business requirements
for a future electronic referral/booking service (60 mins)
3. Next steps - input to future work (10 mins)
Aims of Workshop
1. Better understanding of the benefits of electronic referring and the barriers to effective implementation
2. A view of how a future electronic referral service may look.
3. An opportunity to input into the future business requirements for a national electronic referral/booking system.
How could we make it better to support a future digital world?
• Explanation of Current Procurement Process • Summary of Stakeholder engagement so far • Role of future stakeholder input sessions (like
today)
– Test ideas
– Consider benefits and dis-benefits – anything we have missed?
• for Referrers • for Patients
• For Commissioners • for the NHS
Do we currently have such a tool?
How could we make it better?
What is needed from an Electronic Referral Service?
• A clinical tool for use in the consultation
• An electronic Referral Management System with built in tools to help identify the most appropriate and cost-effective
services for patients in both hospital and community settings.
• Ways of finding alternative care pathways
• Access to specialist advice without referring
• An Educational tool to help inform professional users about
evolving patterns of service provision, locally and nationally and new ways of working
• Access to real-time referral information to support future commissioning plans
• The ability to identify and analyse the referring patterns of clinicians within a commissioning group, leading to more appropriate and cost-effective referrals
• The ability to easily identify spend against contracts, by measuring referral volumes per service and then
attributing costs to those volumes
• Support for proactive contract management by not
having to wait until an appointment has occurred before referral patterns become visible
• Improved support for patient choice and control (“no
decision about me without me”) by providing relevant
information, leading to certainty and reassurance
throughout all the stages of the referral/booking process • A safe, secure and reliable way of transferring referral
information between clinicians
• An easy way of booking an appointment in the correct service
• An ability to review, amend, cancel appointments
What do patients need?
• A tool to support both the quality and productivity elements of the QIPP agenda
• A method of supporting Choice and Commissioning policies
• A system that will bring financial benefits and improved efficiency
Choose and Book
The NHS Electronic Referral
Service
11
How does Choose and Book work?
Consultant/AHP GP Patient Initiate referral Surgery National call centre (TAL) Internet (library) Directly Bookable Internet (home) Hospital call centre Indirectly Bookable GP finds and selects appropriate clinics based on Patient Choice
Group Work (60 mins)
• In the future…what new business processes will need to be supported for each
stakeholder group (patients, commissioners, referrers, providers)
• Consider the new suggested functionality
– What do you think of the idea? – What are the possible benefits? – What are the barriers/dis-benefits
• Do you have other ideas for consideration?
Patients
Self Referral
Allow patients to refer themselves into clinics which are willing to accept self referrals (would need method to identify suitable services and verify patient details etc)
Follow Ups
Allow providers to issue “appointment requests” which
patients could use up to a point in the future to book follow ups if/when required
Enhanced Communication of Appt information
text, email, phone App etc
Commissioners
Enhanced reporting
What information is needed – in what format/presentation is it needed?
Order Control System
Confirmation that referral/booking has taken place – how might this work – would it be useful to have financial information (e.g. costs of appointments) included?
Update and Inform referrers
Provide information to referrers re local services (what sort of information might be useful?)
Referrers
Any-to-Any referrals
Enable midwife to refer to obstetrician or optician to refer to
ophthalmologist and consultants to onward refer. Are there any limits or controls needed?
Better integration with GP clinical systems
What is the vision of a future, fully integrated referral system?
Enhanced Referral Management
•Referral Assessment Services
•Methods of checking that referral criteria have been met
•Enhanced communication between clinicians (e.g. advice & guidance)
Providers
In-built appointment scheduling
What sort of support should be available for organisations that do not have their own automated appointment scheduler?
Uploading information into provider clinical systems
What is needed? – how might this work?
Onward & Tertiary Referrals
Would it be useful for providers to use an electronic system for onward referrals? Should there be limits / restrictions?
Feedback / Next Steps
• Two Key messages from each group • Contact forms for future engagement
Contact Details
Dr Stephen Miller Choose and Book Medical Director
Dr Caroline Tait Choose and Book Primary Care Clinical Lead
Ben Gildersleve Choose and Book Programme Manager
[email protected] www.chooseandbook.nhs.uk
