New guidance on named consultant referrals

Tags: Choose and Book GPs

18 Dec 2008

Named consultant referrals should be available through Choose and Book wherever possible, NHS Connecting for Health has told hospitals.

Revised guidance on making named clinician referrals using the e-booking system says “occasionally” there are genuine clinical reasons for such a referral.

These include referral to a consultant who is known to have a particular interest, previous contact between the patient and a named clinician, and a close working relationship between the referrer and a named clinician.

The guidance says the functionality should be made available to referrers wherever possible to support good clinical practice.

However, it emphasises that patients do not have the right to see a named consultant and that there needs to be a genuine clinical reason for making a named referral.

It stresses: “Named clinician functionality should not be used routinely as it may make it harder for providers to manage appointment capacity and potentially it can increase the number of appointment slot issues.”

The guidance states that if named clinical functionality is set up correctly clinicians will not be “swamped” with referrers. It says the belief among some hospitals that named consultant referrals will impact on their ability to achieve the 18 week wait is largely unfounded.

The guidance advises GPs to seek the support of their primary care trust if a local provider has not enabled named clinician referrals and a genuine clinical reason exists for it being needed.

Earlier this month, Dr Stephen Miller, medical director for Choose and Book, told EHI Primary Care that the Choose and Book team was encouraging trusts to use the named clinician functionality, but that it was keen to ensure such referrals were not misused.

Fiona Barr

Reader's Comments

Then put it in the contract

19 Dec 08 17:12

Working for a PCT it would save me an awful lot of earache if the Trusts all included named consultants. However I am not sure that it is CfHs place to tell Trusts how to run their clinic booking. What functionality have CfH placed in the software to enable "Occasional" referals. Have they even included functionality which allows the recording the reason for a named consultant referral let alone making such a field mandatory for such bookings.

If you allow named consultants how do the 18 week rules and the slot availability rules work. If there are not enough slots for a specific consultant how does the Trusts "Add more capacity to cope"; Cloning?

What happens when it is the wrong consultant who doesn't have that interest or who didn't infact see that patient last time, when there is a clash between continuity of care and specialist interests.

Simply exhorting Trusts to implement this and working through the complex practicalities are very different.

If it is that important there is a simple way of sorting it. The Department should include the requirement in the standard contract.

What about patient choice?

maryhawking@tigers.demon.co.uk

21 Dec 08 09:12

"Revised guidance on making named clinician referrals using the e-booking system says “occasionally” there are genuine clinical reasons for such a referral."

I love the implication that in most cases one hospital clinician is as good as another..

"These include referral to a consultant who is known to have a particular interest" essential in a speciality such as orthopaedics where there *is* a difference - and a patient with a shoulder problem seen by the ankle consultant just gets an internal consultant-to-consultant referral - inconvenient for the patient, expensive for the NHS and, I think, outside the 18 week waiting time diktat. "previous contact between the patient and a named clinician and a close working relationship between the referrer and a named clinician"

In fact, the only reason not allowed is Patient Choice!

Named consultant referrals.

22 Dec 08 22:12

Since referrals made generically and those to referral management centres through Choose and Book effectively destroyed choice for many GPs and not a few patients, this is wonderful news. Of course a balance will need to be struck between popularity of a consultant and system efficiency. There is much more chance of the patient seeing the right specialist, much more chance of continuity save where the patient requests to avoid a particular specialist, and above all a return to the consistent continuing educational relationship through correspondance between the specialist and GP that has been so badly damaged in recent years.