With a patient population of just under one million, Lanarkshire is Scotland’s third-largest Health Board, and the three district general hospitals each see around 70,000 patients each year.
Consultant Connect has been connecting Primary Care clinicians with specialists in Lanarkshire for Professional-to-Professional Advice since November 2020. A few months later, to ease the pressures of Covid-19, Lanarkshire launched their Flow Navigation Centre, consisting of a team of nurses answering calls from GPs referring patients for admission from NHS 24 where it had been deemed that the patient needed to go to the Emergency Department (ED). The Flow Navigation centre also joins up the emergency services and community and social health teams to ensure that patients are directed to the right pathway, first time and receive the best care and support.
Implementing ‘call before convey’ | From 3-day pilot to business as usual
More recently, in August 2023, NHS Lanarkshire launched a ‘call before convey’ pilot encouraging Scottish Ambulance Service (SAS) clinicians across the Health Board to use Consultant Connect to contact local ED consultants, within the Flow Navigation Centre, when seeing patients with non-life-threatening conditions. Clinical discussions conducted in this way enable the consultants to advise SAS clinicians on the best site to direct the patients to, for example specific wards or units, or provide self-care advice with the appropriate community management often bypassing and, therefore, relieving pressure on ED/A&E departments. Where needed, the consultants are also able utilise the pre-programmed numbers within the Consultant Connect App to contact other specialties for advice to provide more holistic care.
Impact:
Following the 3-day pilot it was found that around 80% of calls avoided an unnecessary ED admission, 60% of which avoided an unnecessary patient conveyance with the patient being cared for in the community. As a result, of the successful pilot, the Health Board has received funding to recruit additional clinicians to staff the Flow Navigation Centre. Today, before conveying patients, contacting the Flow Navigation Centre via Consultant Connect is the first port of call when clinicians are seeing patients with non life-threatening conditions.
Hear more from Dr Gordon McNeish, Emergency Medicine Consultant and Project Lead at NHS Lanarkshire Health Board in this short audio clip from our recent webinar:
Encouraging healthcare professionals to use the service
Internal communications have proved crucial in the rollout of ‘call before convey’, with information on how to use the service being distributed to ambulance crews and clinicians within the ED. Ambulance clinicians who were among the first to utilise the service were also asked for feedback and the benefits of the initiative, all of which were disseminated amongst colleagues to encourage uptake.
‘The benefits of this service are there for all to be seen up and down the UK in terms of the ambulance wait times to offload. So if there’s a possibility of the patient not needing to come in, and the ambulance not needing to wait in an ED corridor or outside, then that’s something that can really help everyone. Some of the feedback that we’ve had is that this might be taking away paramedics’ autonomy, but I counter that. We’re relying on their autonomy, their patient observations, and their clinical knowledge.’ – Dr Gordon McNeish, Consultant in Emergency Medicine at the University Hospital Hairmyres, NHS Lanarkshire.
Benefits of the call data
All activity made via Consultant Connect, including phone calls and messages, is recorded and saved within a secure cloud. This allows all service providers to see data relating to their specialty, including answer rates, call times and outcomes, and the ability to listen back to call recordings should they need to. For clinicians at the Flow Navigation Centre, this is beneficial, especially when providing advice remotely as it provides clinical governance in an area of liability. It also enables clinicians to talk through and revisit cases to constantly improve the service. The data reports show the benefits to those contacting the service and exemplify the impact it has on patients.
Dr Gordon McNeish, talked about the benefits of having access to rich data via Consultant Connect – listen to this short audio clip here:
If you have any questions, or would like to find out more about how our services could support your NHS area, email hello@consultantconnect.org.uk or call us on 01865 261 467.
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