This year’s Health+Care Show at the Excel centre was an excellent opportunity for the psHEALTH team to engage with NHS commissioners and providers. In this blog I set out some general observations and some specific feedback on Referral Management.
Despite the enormous challenges ahead, there was still a mix of relief and excitement in the air – no big government-led restructuring and new approaches expected (also not a lot of additional money). The Five Year Forward view has broad support making a successful transition to new models of care more likely. Almost everyone I spoke to was convinced that eventually accountable care organisations (ACO) working with capitated budgets is inevitable as this model offers the best chance to deliver patient-centric, cost-effective care.
As regards to Referral Management, the verdict seems on the one hand clear, CCGs (and eventually ACOs) do not have a choice, they will have to manage referrals to secondary care more actively. One the other hand, there is a debate as to how this is best done: a number of people advocate the use of dedicated referral management or triage hubs (virtual or physical) and there are people who believe that this is the job of individual GPs – all GPs need are more guidelines or maybe some pathway tools they can use during the consultation with the patient.
Although referral management centres have a mixed reputation (mostly because they used to be expensive to operate), it was interesting to hear about the number of CCGs that have them or are in the process of establishing condition specific referral or triage centres. It appears that MSK is not only an area where CCGs are expereimenting with prime contractors, it seems that a number of MSK triage centres are appearing on the scene.
Across the board, everyone agrees that to reduce (or at least contain) the cost of secondary care, we must make sure that referrals are appropriate (unwarranted clinical variation is a big problem) and that referrals increasingly go to out-of-hospital services tailored to the local health economy.
My personal view is that it is very hard to change GP referral behaviour and that the take-up of decision tools when sitting in front of a patient is always going to be hard. We believe in the future the most powerful tool is the use of highly automated referral management centres that can cost-effectively assess the quality of referrals, ensure that local pathways are used and that valuable referral data is used intensively in the provision of feedback to individual GPs and practices. Data can help us both reduce unwarranted clinical variation, but also ensure more consistent take-up of local services.
At the Health+Care show we demonstrated how psHEALTH’s referral management IT solution can fully automate most processes. We can help establish an improved Single-Point of Access capability, delivering a better, more expedient service for patients, GPs and other stakeholders, while dramatically reducing operating costs.
Our unique triage engine fully automates the capture of referrals from a range of media (eReferrals, email or even fax/letters) and uses system intelligence to code referrals, remove most manual processes and help manage the patient referral along prescribed pathways based on locally determined rules.
Read our Whitepaper: The Future of Referral Management