LEARNING FROM ADVICE AND GUIDANCE AUDIT IN GYNAECOLOGY SERVICE IN SOUTHEND UNIVERSITY HOSPITAL
S Rajaram, S Kalkur, A Sahare, J Sowah, C Israel
INTRODUCTION
•Advice and guidance is a two-way dialogue channel in the e-RS which allows GPs to seek specialist input into a patient’s care.
•It provides a secure rapid digital communication channel between GPs and Consultants
•Advice and guidance should be Consultant-led and the Consultant retains responsibility for the service and advice provided
Reasons why a clinician may wish to seek A & G include:
·Clarification (or advice ) regarding a patient’s test results
·Treatment plans and the ongoing management of a patient
·The appropriateness of a referral for their patient ( for example - whether to refer or not / alternative care pathway )
·Identification of the most clinically appropriate service to refer a patient in to
METHODS AND DESIGN
Advice and Guidance Audit is a well-structured inquiry of all patients, placed on A&G request between December 2021 and February 2022. The total number of requests studied were 90. 82% of these requests fulfilled the criteria. Data collection and analysis were done using documents and records. This study was done for purpose of quantitatively ascertaining efficiency of this service and innovation of logical conclusions.
This is an observational study – retrospective cohort study – collection and analysis of data retrospectively done at Southend site of Mid and South Essex NHS foundation trust
OBJECTIVES
•To study Advice and Guidance appropriateness
•To identify the most common reasons to seek A & G
•To study the response times
•To enable referrals to be made to the right specialty at the right time
•To improve quality of care and outcome
This study does not include GPs views about A & G
RECOMMENDATIONS
•GPs should be educated to place request appropriately – by attending GP forums / GPs to fill a proforma before placing request.
•We are in the process of creating guidelines for common Gynaecological conditions and will be available to GPs on ICS website.
•National guidance advises responding within two working days of the advice request being received to maximise benefits. To improve the response times, reminder emails are being sent to Consultants / forwarded to next Consultant on rota
•To develop processes where clinicians work in a team to respond to A & G request to reduce single points of failure
CONCLUSION
Various measures have been suggested to improve the service. Appropriately placing the request and improving response times are two concerns to be addressed
Advice and Guidance has led to
•Reduction in the number of referrals made to secondary care
•Shorter referral to treatment time
•Simplified booking
•Improved patient experience
•Improved referral quality
•Improved communication between primary and secondary care
