The NW London Outpatient Transformation Programme

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To help us with one element of our target to provide safe high quality and sustainable hospital services, we launched our outpatient transformation programme in 2018.

The programme

The aim of the programme is to ensure that patients are seen in the right place, at the right time, by the right healthcare professional, saving patients’ time and ensuring clinical time is used effectively.

The programme will transform outpatient services by improving the quality and efficiency of referrals, from the initial GP referral, to patients receiving the right on-going care.

Getting this right will save patients’ time, both in terms of waiting for and attending unnecessary appointments, receiving the right clinical information quickly and ensuring clinical time is used effectively.

To do this we are working with consultants, patients, GPs and managers, from across all eight clinical commissioning groups and five NHS trusts.

What we have achieved so far

Across NW London we have worked on five clinical specialties to date:

cardiology, dermatology, gynaecology, gastroenterology, and MSk services. We have rolled out a single set of clinical guidelines for each specialty, to be used by all GPs and hospital clinicians in NW London.

Prior to this change several sets of guidelines were in use across NW London and in some areas no specialist guidelines at all.

The use of standardised guidelines will mean that patients are seen with the correct information by the most appropriate clinician. This can reduce unnecessary hospital appointments for patients and it is expected that patients who need to be seen by a specialist in a hospital will be seen quicker.

This project will run until 2021, so please refer back for updates. More information about the programme can be found in our frequently asked questions below.

What is the NW London Outpatient Transformation Programme?

The aim of the NW London Outpatient Transformation Programme is to ensure that patients are seen in the right place, at the right time, by the right healthcare professional, saving patients’ time and ensuring clinical time is used effectively.

The programme will transform outpatient services by improving the quality and efficiency of referrals for patients, from the initial GP referral to the patient receiving the right on-going care.

Who is leading the programme?

This is a clinically led collaborative programme with representatives from all Clinical Commissioning Groups (CCGs) and hospital trusts across NW London, working with partners, patients and subject matter experts. The board overseeing the programme is co-chaired by a CCG GP Chair and the Chief Executive from Chelsea and Westminster Hospital.

Each of the clinical specialty work programme is jointly led by a GP and a senior hospital consultant.

Who has been involved in the development of the programme?

Since the beginning of 2018, consultants, patients, GPs and managers, from across all eight clinical commissioning groups and five NHS trusts, have worked together to develop new ways to shape how outpatient services could be delivered more effectively for patients and clinicians in the future.

What is the timeframe for the programme?

The programme started in January 2018 and is scheduled to run until March 2021. Within this time four phases of work are planned, allowing learning from each phase to support the next as the programme progresses.

The first phase of work started in 2018. This focused on cardiology, dermatology, gynaecology, gastroenterology, and MSk services. The main changes from this first phase have been the launch of new clinical referral guidelines and new clinical referral forms, for use by all GPs and hospital clinicians in NW London.

Phase 2: from December 2018 - April 2019 will focus on neurology, ophthalmology, urology and respiratory services.

Phase 3 clinical areas will be identified in spring 2019 with workshops held in the following months.

What will the programme mean for patients?

The use of standardised guidelines ensures that patients are seen with the correct information by the most appropriate clinician. This can reduce unnecessary hospital appointments for patients and it is expected that patients who need to be seen by a specialist in a hospital will be seen quicker.

In addition patients whose care can be delivered in primary care, based on specialist advice, will not be required to travel to hospital and are likely to receive their care more quickly.

Will patients notice a difference to services?

For most people - there will be no change noticed and patients will attend the hospital appointment arranged by their GP, as the specialist would like to see them.

For a few people – once the referral has been reviewed, the specialist may provide the GP with advice about further tests, care or treatment that can be provided out of hospital. In this case the GP practice will call the patient back to arrange more tests or to talk further about the next steps for care. In these cases if a hospital appointment has been arranged it will be canceled or rearranged.

GPs are advised to inform patients at the time of referral that their direct booked appointment may be canceled or changed following specialist review.

When the changes fully launched in spring 2019, printed information will be provided to patients when their appointment is booked to say that appointments could change following a specialist review.

How have patients been involved in the programme?

An overview of patient involvement in the programme up to January 2019 can be found in this document.

What else is happening in the outpatient programme?

We will also be looking at:

Teledermatology: the introduction of an app for GPs to send images of skin conditions with dermatology referrals for a specialist to review. The app will be tested in spring 2019

Virtual consultations: are currently available in some specialties. We are looking at increasing the use of virtual appointments with specialists clinicians

Referral guidelines for more specialties will also be rolled out later in 2019.

How can I provide feedback on the programme?

Feedback on any aspects of the NW London outpatient transformation programme is most welcome. Please get in touch by emailing nwlccgs.outpatient@nhs.net