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Welcome to this weeks edition of the Planned Care GP Bulletin:

The  focus of this week's bulletin is e-RS with information on the specialties that will become e-RS only from 1 February 2018, top tips when making a cancer referral and other useful information on using the e-RS system. There is also information on Consultant Connect and reminder to encourage all Practices to use the system.

Also includes Other News and e-RS contact details for support and advice


The link to this page can be found every week in the GP Bulletin. To read pervious bulletins, please click here.

We always welcome feedback – please let us know LAMCCG.serviceredesign@nhs.net if you have any ideas or suggestions for the newsletter or on the content.

GSTT and KCH services on e-RS

GSTT services:

As GSTT moves towards receiving 100% of their GP referrals via e-RS, from 1 February 2018 a third tranche of specialties will accept referrals via e-RS only. From 1 February, the following specialties will be e-RS only:


·         Cardiology

·         Ear, Nose and Throat

·         Elderly Care

·         General Medicine

·         Plastics Surgery

·         Respiratory Medicine

·         Sleep Medicine

·         Vascular Surgery


As a reminder, the following specialties are already e-RS only at GSTT:

  • Dermatology
  • Gynaecology
  • Neurology
  • Ophthalmology
  • Diabetes (acute services)
  • Two week wait referrals (excludes paediatrics)
  • Antenatal (this is for GP referrals, patients will still be able to self-refer via other routes).
  • Endocrinology
  • Allergy (adults and paediatrics)
  • Rheumatology
  • Breast (non 2WW)
  • Haematology
  • Nephrology/Renal medicine

     

 

KCH Denmark Hill services:

As KCH moves towards receiving 100% of their GP referrals via e-RS, from 1 February 2018 the following specialties will accept routine referrals via e-RS only:

·         Cardiology·         Paediatrics
·         Dermatology·         Pain Management
·         Diabetic Medicine·         Rheumatology
·         Endocrinology·         Thoracic Medicine
·         Gynaecology·         Trauma and Orthopaedics
·         Hepatology·         Urology
·         Nephrology·         Vascular Surgery
·         Ophthalmology 

 

Referrals for these services that are sent via paper or email after 1 February will be returned to the GP practice and the referral will need to be re-referred via e-RS. Please note, this is only for routine referrals to these specialties and does not include 2WW and urgent referrals


Other hospitals moving to e-RS only

Princess Royal University Hospital (PRUH):

Referrals to all Princess Royal University Hospital (PRUH) services (excluding 2WW) must be made via e-RS. Referrals sent by other means (such as email) will be returned to the GP practice for re-referral via e-RS.

 

Although 2WW services are available on e-RS, they are not part of this closure and are open to referrals via email.

 

Lewisham and Greenwich NHS Trust (LGT):

From 1 February 2018, referrals to 2WW services at LGT must be made via e-RS. Referrals sent by other means (such as  email) will be returned to the GP practice for re-referral via e-RS.


Top tips when making a cancer referral :

1.    Finding 2WW services on e-RS

 

2WW services are found on e-RS by selecting the following:

·         Priority: 2 Week Wait

·         Specialty: 2WW

·         Clinic Type: Select appropriate clinic type

Searching for Two Week Wait services under other specialties will not display the 2WW services available locally

 

2.    Check the type of appointment

 

At GSTT there are three types of 2WW appointments:

 

a)    Directly bookable face-to-face appointments with a clinician: this is the most common type of appointment for 2WW suspect cancer appointments.

 

Specialties with these types of appointments are: Brain – Neurology; Breast; Head and Neck Cancer – ENT; Skin; Urology; Upper GI; Gynaecology; Haematology.

 

Some of these specialties have multiple clinics, please make sure you select the most appropriate service for your patient.

 

b)    Telephone appointment: this is for the 2WW Colorectal / Lower GI Telephone Clinic (straight to test) service.

 

The Colorectal Clinical Nurse Specialist will call the patient at the time the patient has booked into. They will triage the patient and make an assessment over the phone, and will initiate any investigations (if required). The results of the investigations will be reviewed and the most appropriate plan will be made for the patient.

 

Please ensure that the patient's telephone contact details are up-to-date and provide a mobile number if available.

 

This service is not suitable for patients who do not speak English and/or are hard of hearing

 

c)    Referral to assessment (for triage) and then onto appointment (this is a dummy appointment): this is not an appointment for the patient to attend – either in person or by phone.

 

A specialist will review the referral information received from the GP. The hospital will contact the patient by phone to book an appointment into the most appropriate clinic / test. If the patient has not heard from hospital after three working days since they saw the GP, please contact the 2WW Office on 0207 188 0902.

 

This type of appointment is for the following clinics: 2WW Colorectal Assessment (this is a dummy appointment); 2WW Lung (this is a dummy appointment); 2WW OGD only (this is a dummy appointment) - 2WW Upper GI

 

3.    Urgency of the referral

 

Make sure the patient is aware that the referral is urgent and they understand why it is urgent.

 

 

4.    Patient availability

 

 

Make sure the patient is available to attend their appointment. If the patient is not available, then the referral must be deferred until the patient can attend.

 

 

5.    Booking the appointment

 

 

Make and agree the appointment with the patient before they leave the practice. An appointment should not be booked without the patient's agreement.

 

Should the patient wish to book their own appointment (this is not recommended), explain how to make the appointment online or using the national telephone appointment line. The practice will need to monitor whether the patient makes the appointment, and contact the patient if they do not.

 

 

6.    Patient leaflet

 

 

Give the patient a hard copy of the specific 2WW referral patient leaflet which is embedded in each 2WW referral form. This is specific to the clinic type and explains what the patient should expect at the appointment (e.g. the likely investigations, how much time it should take).

 

 

7.    Contact details

 

 

Make sure the patient's contract details are correct, including telephone numbers.

 


Selecting the right services on e-RS

When referring a patient, please ensure that you select the most appropriate service for that condition – the clinic type ‘not otherwise specified’ should only be used when there is not a more appropriate clinic type available.

 

Choosing the right, specific clinic will mean it is more likely you’ll be able to book into an appointment, rather than having to ‘defer to provider’, as the trusts generally have more capacity in sub-specialty services.

 

Information about the referral criteria for each clinic is available on the Directory of Service – please make sure you read it before referring. If you are unsure which clinic to book a patient into on e-RS, please make use of the Advice & Guidance (A&G) function on e-RS. The Trusts will be able to advise where best to book the patient into.


e-RS Guides:


1_How_to_initiate_ERS_v2.pdf

2_How_to_maintain_ERS_Worklist_v3.pdf

4__ERS_FAQ_HaT_v2.pdf

5_How_to_request_ERS_AandG_v1.pdf

7_How_to_initiate_ERS_screenshots_v1.pdf

Key Contacts:

  • Training and Certain ERS issues: GP IT South London Facilitators, nelcsu.gpitsouthlondonfacilitators@nhs.net (All South Lonodn Facilitators have access to this email address, and your nominated Facilitator will respond as necessary. If your facilitator is not available, someone else in the team will pick up any training queries.)
  • Smartcards: Registrations Authority (Tel. 0300 303 2733)
  • GSTT e-RS issues: Arti Trivedi (please do not send patient identifiable information or referrals to Arti)
  • KCH e-RS issues: Crissy Snow (please do not send patient identifiable information or referrals to Crissy)
  • General queries:   Lambeth CCG –  LAMCCG.serviceredesign@nhs.net

 Also contact the Lambeth GP IT Facilitation Knowledge-base for more information and updates from the IT Facilitator


Other News: Consultant Connect

Specialties available on Consultant Connect

A reminder that Rheumatology is now on Consultant Connect. The following specialties are also available:

·         Gynaecology

·         Haematology

·         Diabetes

·         Cardiology

·         Neurology

 

Each GP practice has a unique local telephone number through which they can directly access advice from specialty teams at GSTT and KCH. If you don’t know your practice’s unique telephone number, please contact the Consultant Connect office on 01865 261467, your locality manager will also have a copy of the telephone number or the Lambeth Service Redesign Team  LAMCCG.serviceredesign@nhs.net

PhotoSAF

PhotoSAF is a feature in the Consultant Connect app which allows GPs to take clinical photos using their smart phone. The photos may help GPs to monitor a patient’s conditions, help in an A&G request or enhance the quality of a referral.

 

It is Information Governance compliant as the photos are not stored on the phone’s camera roll and the app requires the patient to provide consent before an image is taken. Photos can be accessed from a secure platform and then uploaded to the patient’s record, attached to an e-RS A&G request/referral or shared securely via NHSmail.


When using Consultant Connect:


  • Please use the practice you are working in’s unique number so the call is logged on the server for the correct practice the patient is registered at. 
  • As a reminder 60-70% of calls are answered if you don’t get through please try again in 10 mins or try the alternative trust if option was available for that specialty. 
  • If you still cannot get through please revert to other means such as e-RS Advice and Guidance. 
  • If you are connected please remember to keep conversations concise and remember to stay on the line and record the outcome of the call. 

 

 Allergy Clinic at GSTT

Pre-appointment preparations

Patients referred to the allergy clinic at GSTT should be advised to stop taking antihistamines before their appointment. Please advise patients the following:

·         Stop taking short acting antihistamine tablets or antihistamine medicine (e.g. Piriton) two days before their appointment

·         Stop taking long acting antihistamines (e.g. Zirket or Clarityn) five days before their appointment.

Please be aware that some cough and cold remedies (e.g. Benylin and Medised) contain antihistamines. Please ask the patient to speak to their pharmacist if they have any queries.

Failure to stop taking antihistamines before the appointment may cause delays in the patient’s care as GSTT may not be able to perform any tests on the day.

Food allergy

For food allergy, if you suspect the patient is allergic to fresh fruit or vegetables, please ask the patient to bring a small quantity of the particular food with them to the clinic.

Clinic locations

GSTT allergy clinics run across multiple locations. When booking the patient an appointment on e-RS, please print out the Appointment Summary and give it to the patient as this tells them where they need to go for their appointment.