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NHS Digital wants to ease delayed transfers of care

Published 27 March 2018

£1.4m fund will help digitise the NHS estate; NHS Digital also said first outpatients’ referrals will be made electronically from later this year in bid to halve missed appointments


NHS Digital has announced the successful bidders of a share of £1.4m to help digitise NHS assessment, discharge and withdrawal (ADW) notices.

The successful local authority-led partnerships are: Dorset, Hackney, Lancashire, Wirral, Worcestershire, Hertfordshire and Rotherham.

The current, non-digital systems in place to handle ADWs had been identified by local authorities and their NHS partners as one of the “stumbling blocks to the transfer of care from health to social care settings”.

This prompted NHS Digital to develop a solution using existing NHS national infrastructure and to offer funding for partnerships to both act as early adopters and to develop the core technology that could be used by other areas at minimum cost.

An expert panel assessed the bids on a range of criteria such as the demonstrated strength of local partnership working, supplier commitment, understanding and mitigation of risks and the overall value for money.

James Palmer, programme head for Social Care at NHS Digital, said, “This funding isn’t going to be the whole solution to delays in transfers of care but as a digital substitute for faxes and post, these projects will help smooth the process of moving statutory key information from a healthcare setting to local authority social care.”

Palmer said, “Further assurance comes in the form of electronic notifications, letting hospitals know that their notices have been received by the local authority. This will help to remove some of the pinch points in the hospital discharge process through helping health and social care to integrate their IT systems.”

This announcement follow the news that all first outpatients’ referrals will have to be made electronically from later this year in a move to halve the number of missed appointments across the country and save the NHS an estimated £50m. .

NHS Digital has announced that patients will be able to choose an appointment at a time and date that suits them when GPs refer patients using the NHS e-Referral service (e-RS).

The switch to electronic only referrals from October 1 will mean doctors and patients will be able to see in advance which services are available and how quickly the patient can be seen.

Patients can book or alter appointments online using a mobile phone or tablet which will save the GP practice time and cuts NHS costs.

The majority of the trusts have agreed target dates for all referrals to be electronic ahead of the October deadline.

Moving to the e-RS system is expected to decrease the rate of patients missing appointments, from 10% to 55.

In 2016/17 there were almost 8m outpatient appointments that patients didn’t attend – the equivalent of 6.7% of the total number of appointments in England.

Currently 19 trusts have already achieved paper switch-off, with more in line to do so before the end of March.

Dr Stephen Miller, National Medical Director of the e-RS programme within NHS Digital, said, “The NHS e-Referral Service helps to relieve the burden on GPs by cutting down on their paperwork and reducing the number of patients who go back to them to find out what is happening with their hospital appointment.”

Dr Miller said, “The system also reduces the risk of letters going missing and allows doctors to more easily track their patients’ referrals.”

Steve Firman, the senior responsible owner for the e-referral programme at NHS England, said, “Fully switching to electronic referrals will have benefits right across the NHS, from cutting the burden on clinician’s time as well as giving patients more choice of date, time and location of their appointments.”

Alex Bickerton, a consultant at Yeovil Hospital, one of the trusts that has made the switch to electronic referrals said, “I think e-RS is undoubtedly the way forward. It is a slick way at looking at referrals and from my point-of-view it means I am not reliant on being in my office and my secretary handing me paper referrals - I can look at referrals and vet referrals at any time”.

Dr Chris Markwick, GP at Carmel Medical Practice in Darlington, said, “e-RS provides a quick and easy way to book appointments online for GPs, their staff and patients. Time from first consultation in primary care to first appointment in secondary care is reduced.

Dr Markwick said, “You can compare waiting times from a variety of providers and offer patients an informed choice. e-RS has enormous benefits for patients in terms of shortening their waiting time. It also allows you to compose and share a referral letter with the patient present, ensuring they are kept informed and understand what the referral is for and that it is accurate.

“This can also form the basis of your notes. e-RS gives you the assurance of knowing when the patient’s appointment is going to be, which, if there is a long wait, allows you to plan any follow-up you might need before they are seen,” Dr Markwick added. 

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