CCGs reduce outpatient appointments with ‘virtual’ consultants

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CCGs in Cheshire have significantly reduced hospital referrals since introducing a pioneering new way for GPs to consult virtually with specialists.

Thirty practices in South Cheshire and Vale Royal CCGs are using Medefer – a service that enables GPs to access online consultant advice and management plans – for patients who may otherwise be referred for outpatient care.

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.

Medefer’s system has been tailored to the CCGs’ needs and capacity of local hospitals. It combines the delivery of 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 provide local GPs with digital advice and guidance for Paediatrics, Haematology, Gynaecology, ENT and Orthopaedics. Founded by hospital clinicians, Medefer is a new way for GPs and their patients to consult virtually with specialists, reducing the need for hospital appointments. It combines a technical platform with specialist clinical knowledge and data insight to streamline the patient journey.

Jonathan O’Brien, Director of Operations, Mid Cheshire Hospitals NHS Foundation Trust said: “This type of platform is very much part of the future of healthcare. It allows clinicians to work more closely together, which can only be good for patients. “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.”

GP Sinead Clarke, who is also Clinical Director for Performance, Finance and IT at South Cheshire CCG 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. “Some patients do need to see a hospital specialist, and we want them to be managed as quickly as possible. If we can care for patients within primary care though, we want to do so.”

Dr Clarke gave the example of a cardiology patient at her practice. “He had a number of very complicated things wrong with him, and I wanted to try a new medication. I did not think he needed an outpatient appointment, but in the past I would have referred him, to get the specialist advice I needed. “Instead, I consulted via Medefer and got a reply from the cardiologist within two days with advice and guidance on how to manage his case. The patient did not have to wait weeks for an outpatients appointment. I was able to sort out his new medication very quickly.”
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