Patient Engagement Group Progress Update on the Referral Management Centre Pilot

In March 2017 the Patient Engagement Group (PEG) were updated on the implementation timeline of the Referral Management Centre (RMC) pilot. The CCG are appreciative of the support PEG members gave to develop the ‘What Happens Next’ patient leaflet.

PEG will be aware that the RMC forms part of Merton Clinical Commissioning Groups (CCG) wider Demand Management QIPP Programme, which is a critical part of the CCG plans around ensuring patients are seen at the right time, in the right place, and by the right clinician. PEG will also be aware that Merton Health (GP Federation) has been commissioned to deliver the RMC pilot.

The RMC is being implemented in two phases. The first phase is to test that the RMC systems and processes are safe and reliable and that the RMC can deliver the expected volume of 800 referralsacross all top eight specialities (Cardiology, Dermatology, Endocrinology, ENT, Gastroenterology, Gynaecology, Neurology and Urology.) The test phase went live 22nd May 2017.

The following provides the current position on implementation of the RMC test phase:

a)Test Sites

The RMC operates from the Lambton Road Practice and is a separate entity to the Practice.

Four (4) Practices (Merton Medical, Figges Marsh, Morden Hall and Central Medical) have been identified as primary test sites and an additional four (4) Practices expressed an interest to be part of the test phase (Mitcham Family, Wide Way, Lambton Road and Grand Drive.)

During the test phase it is inevitable that issues will arise and the main issues related to IM&T and training. The RMC currently has no immediate IM&T issues.

b)Referral Volumes

Currently 250live referrals across all top 8 specialities have been processed through the RMC. The referral volumes are significantly lower than anticipated which is attributed to the IM&T and training issues experienced by the test site Practices.

Referral milestones based on Practice population size and number of whole time equivalent GPs have been produced to enable the RMC to monitor and discuss referral volumes with each test site Practice. The additional Practices will supplement the referral volumes. The RMC continues to proactively promote the service and has provided additional training to the test site Practices.

c)IM&T

IM&T has been a significant challenge during implementation and the CCG IM&T Provider North East London Commissioning Support Unit (CSU) mobilised additional support to resolve emerging IM&T issues including a senior dedicated resource to the pilot which proved invaluable.

In addition the CCG commissioned an organisation called “DXS” to develop and implement the interface systems between GP Practices Point of Care and the RMC Best Triage Plus (BT+.) The CCG acknowledged that DXS BT+ was developmental and would require rigorous testing. DXS respond immediately to issues raised by Practices and the RMC.

d)Quality Assurance

Before implementing the first phase the CCG wanted to ensure the RMC provided a quality service to patients and developed quality assurance metrics that Merton Health had to achieve. The CCG lead Clinicians and Quality Assurance Manager met with Merton Health on 3rd May 2017 and were satisfied they met all the metrics.

In addition the CCG commissioned an independent sector organisation “Apira” to review and provide assurance that the RMC IT systems and operational processes are safe, reliable, functional and secure. Currently Apira are progressing the testing of the RMC live system and will also gather local Practice intelligence on the RMC that will be included in their independent report.

e)Patient and Practice Feedback

The RMC is currently undertaking a rapid questionnaire with every contacted patient. Patient satisfaction is at 95% and patients felt the RMC staff members are polite, courteous and professional and that the RMC contacted them within a reasonable timeframe. The RMC also has the facility for patients to provide feedback via their website.

Verbal intelligence from the test site Practices is positive despite the IM&T and training issues. Practices find the interface between the two DXS systems effective and efficient in terms of reducing their time and effort and they welcome the RMC as a central resource for their referrals.

f)Training

All Merton CCG Practices have received initial training on the DXS system. Additional training is available for individual Practice staff including GPs. In addition a simple Practice ‘how to’ guide has been produced and DXS has developed short training videos that Practices can access.

g)Next Steps

  • The CCG and RMC will monitor referral volumes and promote the RMC with test sites
  • The RMC will monitor IM&T issues and the CSU will swiftly resolve
  • The RMC and CCG will continue to provide additional training to the Practices as required
  • The RMC will communicate progress of the service with all Merton CCG Practices
  • The CCG will approve the implementation of phase two once all issues have been resolved and they are satisfied Merton Health can deliver the service with an increase in the referral volumes

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