The Patients Association: Understanding patient perspectives on improving GP referrals to secondary care through the use of specialist advice and guidance (22 November 2022)

Summary

The Patients Association has been working with NHS England to look at how to improve GP referrals of patients to hospital. The goal was to look at ways specialists could support GPs so they could reduce the number of outpatient appointments patients have to attend, without compromising care.

This report includes an overview of the patient panel workshops, key themes and findings from the workshops, and a set of recommendations.

Content

The workshops brought together a group of patients, whose recommendations for specialist advice and guidance are:

• Establish a three-way dialogue between the patient, GP, and the specialist to ensure patient partnership and shared decision making.
• Streamline the referral process for GPs to get the advice.
• Include pharmacists into the advice and guidance process.

The group also suggested ways to better engage patients in the service:

• Consider the individual’s care and communication needs.
• Allow patients to add information to the e-referral system and increase patient access to their medical records.
• What matters most to the patient should guide the referral
• Provide information to patients on how to manage their health while they wait for the referral or outcome of the advice and guidance request.

To raise awareness of the service among patients, the group suggested that two type of resources: one to raise awareness, and one to provide guidance about the actual service and how it works.

The group also said that since it’s patients who benefit from the specialist advice and guidance service, any evaluation of the service should be patient-focused and provide information on how the service is working for patients and opportunities for making improvements.

The group’s suggestions for evaluating the service are:

• Impact of specialist advice on patient experience, access, and patient journey.
• Impact of specialist advice on supporting greater patient engagement, shared decision making, patient choice, and self-care.
• Patient awareness and knowledge of specialist advice.
• Effective communication and information-sharing during the specialist advice/referral process.
• Impact of specialist advice on equality and health inequalities and ensuring ease and equity of access to care.
• Availability and access to advocacy and assistance services during the specialist advice process.