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Swindon GPs Optimise pathways

29 February 2012   Rebecca Todd

An Optimise screen

A new referral management system created by GPs and hospital clinicians will be launched in Swindon next month.

One hundred referral pathways are in the online Optimise system, which uses check boxes to make sure GPs have tried other reasonable treatments before referring on to secondary care.

The pathways have been developed by GPs and reviewed by hospital consultants.

Dr Peter Crouch is chairman of the Swindon Clinical Commissioning Group - covering 220,000 patients - and director of clinical commissioning for the local primary care trust.

He said the Optimise project was created to deal with a year on year increase in referral activity.

However, the aim of the new system is to bring all GPs within a normal range of referring, rather than to decrease referral numbers.

GPs have agreed a checklist of things they should ask a patient, and other treatments that should be tried, before making a referral. The more boxes that are ticked, the more likely the system is to accept a referral.

Icons alongside the check list give GPs access to external guidance, such as the Oxford Knee Score, which advises on the threshold for knee replacement.  

Once a GP completes the pathway, the referral is sent to a referral management centre run by NHS Swindon to handle discussion with the patient. The centre already handles about 10,000 referrals a year.

Dr Crouch said he had a golden rule that each pathway should take no longer than 75 seconds to complete - or GPs would not use it.

He said this had meant that in some cases consultants had to significantly pare down the list of questions GPs should ask their patients prior to referral.

However, he said that some had conceded that many of the questions were actually of “no use at all” once they were examined closely.

“Just designing the pathway has got them [GPs and consultants] to discuss what should or should not be done,” Dr Crouch added.

The software can always be over-ridden by GPs, so it does not take away their ability to refer if they really want to.

Dr Crouch also said the pilot software had been extensively tested to make sure patients did not “fall though any cracks in the system.”

A number of neighbouring PCTs have shown an interest in buying Optimise, and NHS Bournemouth and Poole has already signed up.

Dr Crouch said the system was being offered to other trusts for just £17,500 on condition that any new pathways created by GPs would be available to all users. The system goes live in Swindon on 13 April.


Related Articles:

News: DH sets out public health data roles | 24 February 2012
News: Torbay CCG buys Contract+ for practices | 23 February 2012
News: Cornish PROMS site changes pathways | 15 February 2012
News: More comissioners use PathFinderRF | 10 February 2012
Last updated: 4 April 2012 12:39

© 2012 EHealth Media.


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Link this to Confer (NHS East of England)

simonjhudson 125 weeks ago

This, combined with the Confer programme piloted in NHS EoE would create a great tool set:

http://www.ehi.co.uk/news/ehi/6978/east-gps-and-consultants-confer

S W London recently went to tender for this too.


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League of Gentlemen strikes again

Daniel Defoe 125 weeks ago

With respect Dr Swinyard, Dr Crouch's system does appear to be a "local service for local people". While this is great in some cases, if I had a cardiac complaint, I'd want to have some sort of choice between e.g., Bristol and Oxford, or perhaps even wider, and C&B actually allowed me to express that to my GP. Could it be that there's room for both Optimise and C&B?

Incidentally, I think we clinical IT professionals would love to learn more about "...Dr Crouch also said the pilot software had been extensively tested to make sure patients did not %u21Cfall though any cracks in the system.%u21D". Where can we see details of this extensive testing please?


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not exclusive

Swinyard 125 weeks ago

Whoever the pseudonmyous Daniel Defoe is, this system does not exclude choice for enthusiasts who like to use C&B. We have not routinely used it in our practice for a couple of years except for the rare - very rare - occasions when someone wants an out-of-area referral when it has its uses. But it remains clunky. Paper referrals do the job for us, for now, until something better like Optimise comes along.


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When someone wants an out-of-area referral???

Daniel Defoe 125 weeks ago

Gordon Bennett (to quote another pseudonym) - you only use C&B when "...someone wants an out of area referral..." rather than routinely? OK. You're the Primary Care clinician, and if you want to carry on using paper, then fine.

Any chance of an answer to the second part of my question about the "extensive testing" of Optimise, or is yours one of the practices that requires separate appointments if you have two matters to consult you about?


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brilliant system - makes C&B redundant

Swinyard 125 weeks ago

Swindon has a history of e-referrals before they were subsumed by the lumbering colossus of choose and book. This new system is intuitive, evidence based and user friendly. The "choice" discussion lands in the referral management centre and the clinicians can get on with being clinicians and looking after patients, rather than wading through C&B menus. This is what happens when you allow IT-literate GPs (like Peter Crouch) free rein and encourage innovation. Award-worthy. Dr Peter Swinyard, National Chairman, Family Doctor Association


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