It’s been over a week since NHSE published “Reforming Elective Care for Patients”.
The response we’ve heard from NHS colleagues has been enthusiastic: ‘It’s definitely better for patients, and, provided consultants are job-planned so that responses don’t take forever, should be better for hospitals as well’ was the response of a senior consultant we spoke with.
As a quick reminder of what the reforms include:
- Funding is going to be targeted at activity that reduces a patient’s wait for care
- Advice and Guidance (A&G) and clinical triage/list validation are central to these reforms
- GPs will receive £20 per A&G request
- Hospitals will receive a new A&G tariff
- Triage/list validation will receive a new tariff
- Consultants will be job-planned to carry out this work
- Hospitals that reduce their waiting lists fastest will be financially rewarded
Here are summary answers to the two main questions we have been asked:
1. How will hospitals get the clinicians necessary to deliver this additional work?
- Although A&G and triage/validation will ultimately reduce “per referral” activity, waiting lists still need to be worked through, and demand is rising
- Will job-planning A&G/triage mean that waiting list growth will be reversed, meaning you can have the same or better impact on waiting lists whilst running fewer clinics? We think this is possible, but too difficult to be sure; we expect to see real-life data on this in 2025
- This leaves Trusts with two options: find additional clinicians AND/OR streamline A&G/triage processes so clinicians can get more done
- We expect a rise in the use of remote clinicians; our National Consultant Network handles A&G requests and referral triage/validation both on Consultant Connect and e-RS remotely; convenience for the clinicians means that the cost per case is very low – we expect locum providers to move to offering this sort of model
- “Widgets” will be made available that work with e-RS to improve the user experience; we’re just rolling out our first e-RS Connect project (report coming early 2025!), which we expect to reduce the time it takes for a clinician to respond to an A&G request by half
2. How will we track activity / get paid?
- We’ve had questions on this from GPs and Trusts: there have been reporting issues with e-RS in the past, and there are concerns that these have not been addressed
- For GPs unhappy to rely on e-RS reporting data, we would suggest maintaining an additional spreadsheet of A&G activity to double-check against official reporting
- GPs using Consultant Connect (written or telephone) can call off reporting to submit to their ICB
- Some Trusts are concerned that, once an A&G case is returned, it is not recorded – again, although a pain, a separate spreadsheet can prove a useful exercise for a few months to confirm reporting is accurate
- Our e-RS Connect widget, as well as making e-RS A&G quicker, provides complete reporting, including auto-generated spreadsheets and summary patient activity for the Trust EPR
- e-RS Connect also keeps records of all A&G transactions, meaning the advice does not simply vanish from the wordlist – this can be exported into the EPR
- Both Consultant Connect and e-RS Connect are integrated with EROC reporting requirements
- We expect Trust remuneration to be through EROC returns
For support or more information:
Please let us know if you need any further help or if you’d like to have a look at our reporting or learn more about our National Consultant Network: email us at info@consultantconnect.org.uk or call us on 01865 261 467.
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