World Cancer Day: using Consultant Connect to support with USC pathways

Using Consultant Connect has become the gold standard within the dermatology team at University Hospitals of Leicester NHS Trust (UHL). Taking and sharing safe clinical photos via the PhotoSAF function within the Consultant Connect App is incorporated as part of the booking process for all patients undergoing surgery for suspected skin cancer and as an alternative way to reduce the risk of clinical error, such as wrong site surgery. This enables the clinician to search for and review the patient’s images and notes on the Consultant Connect platform before and during surgery. Over the last 12 months*, the dermatology team at UHL has taken and shared more than 28,000 photos via Consultant Connect.

‘Dermatology services are changing, and some patients will have their procedures performed by community providers. So, having a system like Consultant Connect will add a layer to the Swiss cheese model and help perform safer surgery.’ – A consultant dermatologist at UHL.

In Medway and Swale ICP, clinicians have access to Messaging Advice & Guidance (A&G), enabling them to securely send messages for advice and attach files/photos as needed. Due to locally unavailable services, many of the specialties provided are delivered by out-of-area NHS consultants on the National Consultant Network (NCN). Since the project’s launch in 2019*, 700 messages have been sent, and on average, they have been responded to within two hours.

‘A patient presented with deficient levels of vitamin D and a history of ongoing malignant melanoma. Their cancer treatment meant they had to avoid sun exposure completely, and with their low levels, a very high dose of vitamin D was clinically indicated, according to NICE CKS. A loading dose would benefit the patient for a certain length of time. Still, before commencing, especially for oncology patients, this treatment should be discussed with a specialist to determine whether there is additional guidance or therapies to consider. I sent a message to a consultant in palliative care on the NCN outlining my plan and asked if, based on their experience, there was anything they would change. The consultant agreed with my approach, which enabled me to initiate the patient’s treatment the same day, and they avoided a hospital referral.’

– Dr Funmilola Adigun, GP in Gillingham.

To meet and combine seamlessly with the new Children’s Cancer and Leukaemia Group guidance, the University Hospitals of Coventry and Warwickshire NHS Trust (UHCW) set up and launched a new ground-breaking Paediatric 2WW Pathway via Consultant Connect. The services comprises a telephone and messaging line used concurrently, allowing primary care clinicians to call specialists at the touch of a button and then follow up with a message, attaching clinical images, reports and/or documents if an urgent referral is advised. Queries are monitored by a rota of local consultant paediatricians and cancer specialists, with backup provided by acute general paediatricians as needed, fitting in with clinicians’ existing schedules. The pathway bypasses the hospital switchboard and has dramatically sped up cancer diagnoses for children and young people, fast-tracking patients with concerning symptoms for specialist treatment. In the last 12 months*, the telephone line has received 257 calls, answered within 18 seconds on average. 41% of all calls resulted in the patient avoiding an unnecessary 2WW referral, allowing them to be cared for within the community and alleviating any anxiety.

‘Providing advice via Consultant Connect means we’re connected with clinical colleagues immediately. I can gather additional information that enables clearer decision-making about whether the child needs to be seen the same day in ED, or as soon as possible in an outpatient clinic, or even that they don’t need to be seen in secondary care, and we can advise other investigations or a “watchful waiting” approach. The messaging function means that contextual data, such as diagnostic results, can be securely shared and further communication can continue between the clinician and consultant involved.’

– Dr Kim Neuling, Consultant Paediatrician at UHCW.