Using an innovative ‘Virtual Hospital’ model of planned care, three Clinical Commissioning Groups (CCGs) in London have significantly reduced avoidable gastroenterology hospital outpatient appointments.

Over 100 GP practices across Barking and Dagenham, Havering and Redbridge (BHR) use the NHS e-referrals Service (eRS) to access Medefer’s Gastroenterology “Virtual Hospital” for outpatient services.

This specialist service offers GPs all the function of planned care hospital services, including specialist investigations, within the community setting, whilst avoiding any further workload and pressure on primary care.

The service, which went live in March 2017, has managed over 70% of all new Gastroenterology referrals in the community, reducing hospital footfall, whilst delivering 30% cost savings for the CCGs.

Other key highlights of the service include an average response time by consultants of 5 hours, a significantly shorter referral-to-treatment times (less than 7 weeks), and very high patient satisfaction.

As of March 2018, Medefer’s service has been the fully mandated referral service for all medical gastroenterology GP initiated referrals in BHR (excluding 2WW).

Mr Rodney, a patient who received specialist care through Medefer’s Virtual Hospital pathway, said: “I received everything on time, better than the NHS would usually handle things, there was no down side, and it was a new experience for me”.

Dr Adam Stone, a Consultant Physician and Gastroenterologist at St Richard’s Hospital, Chichester, works as part of Medefer’s national network of specialists. He said: “Medefer’s Virtual Hospital pathway turns months of delays replying to GP referrals into the matter of a few hours, results in a Consultant opinion being offered on the information supplied, relevant investigations arranged promptly, and results interpreted, and advice given rapidly once the results are available.”

In addition to the ‘Virtual Hospital’ model, Medefer also provides an Advice and Guidance service covering 14 specialties across multiple CCGs. Medefer’s system has been tailored to the Cheshire CCGs’ needs and the capacity of local hospitals, providing rapid and reliable access to specialists to the 150 Cheshire GPs.

Jonathan O’Brien, Former Director of Operations at the Mid-Cheshire Hospitals Foundation 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.”

Dr Sinead Clarke, the Clinical Director for Performance, Finance and IT at South Cheshire and Vale Royal CCGs and a GP in Cheshire 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.”

This ‘Virtual Hospital’ model of care enables a rapid, efficient, cost effective and scalable transformation of planned care services while utilising Medefer’s powerful platform to create a “National Grid”, virtually redistributing the pressure and workforce across NHS Trusts or CCGs.


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