It’s time to save…and here is how. Chapter 1: Reduce Referrals

As the NHS faces a prospective funding gap of £30+ billion and GPs take the lead for commissioning services, there couldn’t be a better time for efficiency savings. Reduce referrals, share resources, cut costs: while the magic trio has never been higher on CCGs’ agenda, everyone seems to be left wondering how?

In their recent ‘Referral Management – Lessons for Success’ study, Candace Imison and Chris Naylor reckon that “greater use of new technologies could be an important enabler”. That’s right: in a world driven by innovation, there must be some software, somewhere, able to address this simple problem. I say “simple” and I mean it: compared to the problems solved by business intelligence systems in the corporate world, what UK Primary Care is trying to achieve is a piece of cake.So, where are these tools?

Right here. They’re just not where you expected them to be

Digital Dictation & Referral Management (DD & RM) technology. That’s the name of the game. You all know about it, but such systems are typically deployed at practice level. As a result, CCGs end up with 2 or 3 different systems to maintain, and most importantly, they can’t reap the massive benefits of a central implementation. So I believe it’s time for me to shed light on these benefits and the kind of savings they yield. Then the question won’t be “if a central Digital Dictation system implemented CCG wide can bring the long awaited efficiency savings” anymore, but “when”.

Manage Referrals CCG Wide

General practitioners make more than 9 million referrals each year, triggering many billions of pounds of expenditure. And still according to Imison and Naylor, “GPs’ capacity to refer appropriately would be greatly strengthened by access to decision-support tools, up-to-date information on local services, and regular feedback from audit of their referral activity.”

May I go a notch further by claiming such tools are a ‘must have’? Yes, for once you have a central DD & RM system in place, cutting costs becomes a doddle. All it takes is for the system to be ‘hosted’, as in ‘deployed on a virtual server with all practices connecting to it via the N3’. The system also needs to work in real-time, streaming files to and from the central server as opposed to duplicating them like papercut flowers on a Christmas card. And if you start looking around, you’ll soon find out there’s only one supplier fitting the bill: Crescendo.

So what happens at the point of referral when clinicians dictate with Crescendo: in addition to the automated patient demographic entry, clinicians are asked to select the speciality and referral type from a customisable “smart list”, which can mirror NHS England’s E-referral service specialities and clinics. This data is then captured by the system, so the next logical step is for the system to provide a dashboard, right?

Right. The ‘front screen’ of the dashboard gives you a real time view of your highest referring GP’s and your most efficient secretaries. There is also a live count of the number of referrals current, pending and awaiting transcription with average turnaround time from dictation to transcription displayed in hours and minutes. Drilling into the reports allows you to:

  • Track Referrals in real-time: Detailed breakdowns by speciality, type, practice and individual GP lets you see exactly what is going on, when and where.
  • Analyse Referral Trends: The dashboard can tell you, in just a few clicks, who are the higher referring practices/doctors. And that’s just one example of the many detailed reports you can get for any given period, including year-on-year.
  • Control Referral Costs: You can validate actual use of lower cost, community based services while ensuring over-average referrers are bought into line with the rest of the CCG. Cherry on the real-time cake: you can also measure the use of Local Enhanced Services.

So having a dashboard like this one feels like a new pair of glasses: no more stumbling. And the savings achieved through tools like these alone will pay for your DD & RM investment within a year or two.

And it’s just a start. Next time, we will discuss how a centralized DD & RM system allows you to pool and share secretarial resources, in just a few clicks. Stay tuned to find out why your practices may never have to hire another temp.


The Equalizer

Message from First Practice Management - This article has been provided by the blog site The Microphone – Plugging into Crescendo The Microphone brings together the primary care community around digital dictation and referral management technology. On this blog you can find thought leadership articles, news, interviews and case studies from GP surgeries.

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Damion Mikulecky 08/08/2015

A big thank you for your blog article.Much thanks again. Much obliged.

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Closing Date: 3 June 2020

Salary: In line with Whitley scale 7

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