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Referral Management & Choice Tower Thistle, London 13th May 2004.

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Presentation on theme: "Referral Management & Choice Tower Thistle, London 13th May 2004."— Presentation transcript:

1 Referral Management & Choice Tower Thistle, London 13th May 2004

2 The Role of the RMC in Systems Reform The Wakefield West PCT Referral Management Centre

3 Background History of waiting list and waiting times problems Identified capacity gap Financial Control Plan Referral levels comparable with benchmark Need for demand management, alternatives to secondary care, increased capacity in primary care, protocols and guideline Poor referral information Emerging policy on Booking and Choice

4 Referral Information No regular, timely, detailed information available QM08R not at practice /gp level No information at sub specialty, consultant, or reason for referral level Local provider data on request but 6 months out of date No other provider data

5 Intended Benefits of the RMC Accurate and timely referral information available within the PCT in order to understand demand Accurate and timely information to feedback to practices to raise awareness of own referral patterns and comparative referral patterns (numbers, per 1000 population, deprivation scores Information on referrals to all providers Information on which to assess potential of GPwSI developments and to scope GPwSI services Early identification of referral patterns – peaks in referrals leading to peaks in waiting lists, shifts to other providers

6 Intended Benefits of the RMC cont/… Opportunity to influence referral patterns Opportunity to monitor referral guidelines Information on which to review commissioning decisions and assess impact of PBR Possible use of information to look at equity of access issues Potential to book appointments for GPwSI services. A central contact point for patients to enquire about a referral and reduce calls to general practice Potential to book outpatient appointments Potential to facilitate patient choice

7 Initial Scope To receive and log all routine GP referrals, for outpatient consultation, to secondary care To receive and log copies of urgent cancer and RACPC referrals To provide monthly and quarterly referral reports to PCT and to general practices To monitor activity against SLAs To monitor implementation of guidelines To answer patient queries o the progress of their outpatient referral and average waiting times for first outpatient appointments To inform developments in demand management To inform development of GPwSI services

8 Referral Management & Choice Tower Thistle, London 13th May 2004

9 Referral Management Centre - what does it do? Dr Mark Napper Medical Director

10 Current Functions of Referral Management Centre Accurate and comprehensive data on GP referrals –Analysis by practice, provider and speciality –Analysis by presenting problem –Trend analysis –Reports fed back to practices

11 Provider analysis

12 Analysis by Speciality

13 Analysis by Provider and Speciality

14 Analysis by Provider and Speciality (2)

15 Number of Referrals by Practice

16 Rate of Referral by Practice

17 Trend in Referral Rate by Practice

18 Surgical Referrals

19 Dermatology Referrals by Presenting Problem

20 Current Functions of Referral Management Centre Responding to enquiries from patients, carers and practices Choice Cataract Pilot (patient care advice)

21 Current Functions of Referral Management Centre Choice at 6 months (patient care advice) Booking for Primary Care Musculoskeletal Service Intercepting referrals for services outwith commissioning policy

22 Referral Management & Choice Tower Thistle, London 13th May 2004

23 Extended Role Booking of GPwSI Service Managing referrals to other gateways Implementing process for Choice@ 6 Months Implementing process for Choice @ Referral Pilot in cataracts PCT management of potential 9 month waiters Identification and tracking of GSUPP 1 patients, management of referrals process Implementing Choose and Book

24 Choose and Book Will the national e booking system provide PCT level referral information of same level of detail from December 2005? What part of the Choice process will be delivered in general practice? What service will the NHS Direct Booking Management Service provide? What is the role of PCTs and how can they deliver it? –Selection of 5 providers –Levels of activity commissioned –Monitoring activity against SLAs –Monitoring capacity –PCT managed waiting lists –Informing Plurality –Central referral and contract management options

25 Choose and Book cont/… The development of more dynamic contracting is likely to require: –Pooled contracts to share volumes across PCTs – Real time information on referral patterns –Agreement on referrals and conversion rates –Active management to switch activity around the system to meet preferences Different patients will require different levels of support in helping them choose – clinical and non-clinical support. - PCTs are expected to provide a range of support services appropriate to their local populations

26 Choose and Book cont/… Where electronic booking is not in place by December 2005 paper referral will have to be made and patients should expect to be able to book the time and date of their secondary care appointment within 1 working day of the referral reaching the secondary care provider. Alternative local arrangements will be required to support booking and choice in any areas without access to the Electronic Booking Service How will a national solution identify different streams of patients – e.g. free activity, national IS procurement activity, local IS procurement activity?

27 Referral Management & Choice Tower Thistle, London 13th May 2004

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