The “normal process”
Historically a GP would diagnose a problem and then refer that problem to a surgeon for consideration of treatment. Unless the patient was ill that referral would generally be made without further consideration, basically determined by the presenting condition. If you were ill or frail that would be considered as to whether surgery was the right option for you. The time taken to assess and refer would usually take up the whole consultation
This “trial process”
Recognising that the consultation is already pretty busy, we are looking at offloading this “optimisation process” to another point. Having looked at it in the Falkland Surgery, we refer approximately 150 patients (out of 14500) per month or about 1% of our list, to a surgical colleague (not necessarily for surgery). This excludes 2 week wait cancer referrals.
We now search for these patients and send each of them a mail-merged letter explaining this project, and giving the last known values for the parameters (alcohol, smoking, BP etc) and inviting them to visit this website.
We are also adding blood test forms for those with identified Past History of anaemia, and if diabetic if their latest HbA1c was either high or more than 3m old, and inviting those with latest high BP to get these rechecked. These will then be processed as per “normal care” of the results.
We have set up searches monitoring referrals to see if the values at referral and at 6months after referral, change. Historically these have not been shown to change significantly.
We have set things up so we have a cohort of patients referred in 2015, and will compare them to the cohort starting now to see if the parameters are changed by this intervention