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Your spotlight on local services

Improving Referrals to Outpatient Care


Patient experience suggests that most people are happy with the actual care that they receive but that concerns do exist regarding the referral and appointment booking process. Patient concerns included confusing communications, being told they 'Did Not Attend' an appointment that they had never been advised of, being unclear as to who to contact.

As a result of these concerns we have explored the complex pathways that patient's enter when their GP refers them to an outpatient appointment and published a report that hopes to explain these and recommend improvements to the process.

There are several organisations involved in processing an appointment and the organisation changes depending on circumstances and the part of the process the appointment is at.

Different systems are used for referring and booking appointments by each organisation and GPs across Richmond are free to make their own referrals or to outsource the administration to a booking service.

We conclude that there is a significant difference between the experiences that patients have shared with us of their care and the ambition for a robust and fail safe referrals system.

This situation appears to be instrumental in creating the challenges that patients have shared with us. Our report identifies many of the problems within the referral process and makes specific recommendations as well as calling for leadership from Richmond CCG to resolve these issues and set up a process of clear oversight for referrals.

Whilst there is much to do to improve the systems it is clear that NHS outpatient care is changing. There are many improvements on the horizon and the move of appointments out of Hospital and into the community presents both opportunities to improve and challenges for managing the change.