We are delighted to see more commissioners looking to referral management to improve patient outcomes and contain cost: the project at Birmingham CrossCity is a good example. As a country we are faced with a seemingly unstoppable demand for secondary care and we have to find ways of getting better value out of every pound spent. With an increasing number of lower-cost community services, it is often hard for GPs to ensure the right patient is sent to the most appropriate service.
The problem to date has been that the cost of operating referral management centres can be very high. Our software can automate most of the administration aspects of referral management and reduce those costs dramatically. The other benefits of automation of referral management are faster turn-around times and very accurate data collection.
Below I have set out the summary of the CrossCity tender document – happy reading.
Contract Description: Referral Triage Services – NHS Birmingham Cross City CCG
NHS Midlands & Lancashire CSU
Clinical Triage is a way of monitoring; directing and appropriately managing patient referrals with the aim of ensuring that the most clinically effective and cost effective outcomes are achieved, whilst at the same time respecting patients’ rights to choice (as defined in the NHS Constitution). NHS Birmingham CrossCity CCG is looking to commission a twelve month pilot to deliver referral triage services for all elective referrals from primary care from April 2016. The outcome of the pilot is to test proof of concept which is driven by impact on patient experience, data collection and clinical quality.
The service must have the ability to receive and check referral documents from NHS Birmingham CrossCity CCG member practices in line with commissioner specifications, thresholds and referral guidelines ensuring high quality and consistent clinical assessment service in line with the information detailed in the data recording and reporting section of this specification. The service must work within the following parameters:
• Interoperability with national E-referrals system and which does not adversely impact the achievement of the CCG’s achievement for e-referrals usage trajectory.
• A working knowledge of the local economy in Birmingham to include acute trusts all healthcare provider services.
• Have capability to process all elective referrals by a senior clinician/consultant.
• Have mechanism to provide GPs with education/feedback which includes high quality feedback to GPs proposing a management plan that ensures that the GP can effectively care for the patient outside of a hospital as part of the requirements of the NHS GP contract, agreed shared care protocols with secondary care or through the CCG Aspiring to Clinical Excellence Scheme.
• Ability to engage and work with secondary care providers, building strong professional relationships.
• Ensure the service is Consultant Led
• Ability to collect a range of qualitative (clinical and patient experience) and quantitative (activity) data on referrals, clinical decisions, patient experience, referral trends and skills and service gaps as defined in the performance monitoring information.
• Able to collect feedback from GPs on their views of the service as well as patient views.
• Able to triage, assess and arrange appropriate action within 2 working days of the receipt of referral.
• Model of delivery to be operational with effect from April 2016
Location of Provider Premises:
The location of the providers premises from which this service is to be delivered must be in the geographical area of the West Midlands. This is because the service forms a critical part of the on-going patient care and integration with existing local care systems will be an important part of the evaluation.
The pilot contract duration will be 12 months with an option to extend for a further 6 months.