An evaluation of an eReferral Management & Triage System for MOS referrals

1. An evaluation of an eReferral Management & Triage System for MOS referrals HSD&R – 11/1022/15 Iain Pretty, Paul Coulthard, Joanna Goldthorpe, Lesley Gough, Anne Begley.

2. Update • To update practices on data so far • Described the activity levels and case complexity within the service • Describe what the DES practices may be providing • Demonstrate triage system • Get feedback on system and forms

3. Data • We have been collecting data on the submitted referrals since January • They demonstrate almost 100% compliance with the online system • Ortho and child only providers excluded • Monthly data flows suggest around 50 – 70 minor oral surgery referrals

4. Monthly Data

5. Breakdown of activity

6. Care pathways Securing Excellence – the new contract? 3 Cases requiring outpatient care or care from a Consultant led team Level 2 Advanced level care that can be safely delivered in a primary care setting by a practitioner with additional skills and who may be on a specialist list. May be consultant supervised. Level 1 Primary care procedures that should be delivered by and within GDS contracts

7. Tier Levels • Tier 1 - >2 % • Tier 2 – 60% • Tier 3 – 37.5% • Remainder sedation

8. Tier Levels • This suggests that over 60% of referrals could be seen in a primary care oral surgery service • Given the current referral numbers this would relate to approximately 40 referrals per month • This could be seen by 2 or 3 providers • Activity is third molars, complex extractions, roots and apicectomies.

9. Triage • For the primary care services to work efficiently a triage system is required • This directs referrals to appropriate providers • This is undertaken by consultants in oral surgery and maxillo facial surgery • Simple system, independent of providers • Will not delay patient journey

11. Triage • Enables rapid sending of referrals via NHS NET • Enables identification of 2WW referrals • Enables referrals to be automatically directed to nearest provider to patient • Can utilisecapacity efficiently across all providers • Need to agree what to do with Level 1

12. Procurement • Area team will discuss the stages and timelines for procurement • Will be based on a service specification informed by the health needs assessment

13. Next research stages • “Switch on” triage in January 2015 to feed cases to the primary care providers • Ensure that quality is maintained • Work on health economics • Work with interviews of stakeholders

14. Your feedback • Jo has interviewed several practices • Feedback on following phone requests • What do you like? • What do you dislike? • What could be done better? • Let us know or fill in the form

15. Thank you For your attention iain.pretty@manchester.ac.uk