CCG News, Primary Care News

Virtual consultants help CCGs significantly reduce outpatient appointments

Cheshire clinical commissioning groups (CCGs) have significantly reduced hospital referrals with a new digital service that could be replicated across the NHS.

Thirty practices in South Cheshire and Vale Royal CCGs are using Medefer – a service that enables GPs to access ‘virtual’ consultant advice and management plans – for patients who may otherwise be referred for outpatient care. The results of the pioneering work in Cheshire are being released today (28 June 2017) at the Health + Care conference in London by Medefer’s co-founder and CEO Dr Bahman Nedjat-Shokouhi.

The company is working with a total of seven CCGs across the country.

In the past 12 months (since July 2016), Medefer has enabled around 150 Cheshire GPs to manage in the community 77%* of patients they refer to the service – significantly reducing unnecessary hospital outpatient appointments.

GP Sinead Clarke, who is also Clinical Director for Performance, Finance and IT at South Cheshire CCG. She said: “I really like using the Medefer service, and the feedback has been almost universally good from my GP colleagues. The referral form is easy to fill in, and pulls in a lot of information from the patient’s medical history, which means the consultant has a rich data set from which to begin reviewing the case. We get a much quicker response than if we had referred the patient for an outpatient appointment.”

Founded by hospital clinicians, Medefer combines a technical platform with specialist clinical knowledge and data insight to streamline the patient journey.

Medefer’s system has been tailored to the Cheshire CCGs’ needs and capacity of local hospitals. It combines advice from specialists at the local hospitals and Medefer’s national network of consultants, who provide extra capacity to the local health system in three major specialties: gastroenterology, cardiology and respiratory.

Further specialties are provided locally by Mid Cheshire Hospitals NHS Foundation Trust, which uses the Medefer platform to give local GPs digital advice and guidance for Paediatrics, Haematology, Gynaecology, ENT and Orthopaedics.

Jonathan O’Brien, Director of Operations at the Trust said: “This type of platform is very much part of the future of healthcare – and allows clinicians to work more closely together. The reduction in outpatient referrals has of course reduced waiting times for the patients who do need to be seen in hospital. Meanwhile, 95 per cent of patients who can be managed by their GP are getting advice and guidance within 48 hours.”

Mr O’Brien said the system also enables a clear audit trail to ensure it is working well. He added: “There is a formal electronic record of all requests for advice and guidance. So we can measure when it happened, who it came from, how quickly the hospital specialist acknowledged it, what action was taken, and whether the advice was acceptable to the GP. This provides assurance to us that the system is robust and action is taken to ensure the patient’s care is progressed in a timely manner.”

Dr Rama Vancheeswaran, consultant integrated respiratory physician at the Royal Free London NHS Foundation Trust, works as part of Medefer’s national network of specialists. She said: “If this type of service were rolled out across the NHS, it would significantly improve the quality of service to patients, whose treatment is being delayed because need outstrips capacity. I estimate we could reduce respiratory outpatient appointments by 40 per cent with Medefer, enabling us to give the right care earlier. Nationwide, we are talking about major financial savings on unnecessary outpatient appointments.”