Referral management centres
The elective referral management service provides seamless management of locally defined pathways, ensuring the patient is seen in the most appropriate setting. The service is the single point of entry into the local healthcare system for scheduled GP referrals to hospital or other agreed dispositions such as Tier 2 or CAT services. The service also manages hospital consultant to consultant referrals.
The service provides data capture, clinical triage, signposting and Choose and Book bookings (or onward referral to service providers) for all first referrals in agreed specialisations, in line with the commissioners' authorised pathways and evidence based clinical guidelines.
Clinical triage provides peer review of referrals and signposting to appropriate services and facilitates a program of continued education for referrers.
The reporting suite provides full data sets for all out-patient referral activity. This enables gaps in service provision to be identified to inform future commissioning intentions, including implementing more cost effective primary care services.
Harmoni's referral management centre service model has six key components: access, assessment, signposting and booking of appointments, treatment, self management and planning.
Access
The referral management centre can be accessed by GPs and other healthcare professionals by telephone, fax, and email.
Assessment
Clinical triage is undertaken by appropriately qualified and experienced clinicians (GPs, GPSI's, Consultants or Consultant Supported Healthcare Professionals). Where possible, they will be sourced from within local health economy boundaries as they will be best placed to understand the available care pathways and local service restriction policies.
The assessment is recorded directly into the referral record with one of the following outcomes:
- Signposting to the most appropriate service for the patient
- Advice and guidance back to the GP
- Rejection of referral based on the locally agreed non commissioned procedure list
Referrals for conditions included in the commissioner's service restriction policy are returned to the referrer with an accompanying notification that outlines the local appeal process for non-commissioned procedures.
Signposting and booking
Once the best pathway has been agreed, our administrators book the patient into the appropriate care provider. We can integrate with the local Choose and Book system or liaise directly with the acute booking service when making hospital appointments. If the patient is to be treated in the community, we make the booking for the patient and reconfirm again nearer the time, reducing non-attendance rates by approximately 50%.
Treatment
Harmoni's referral management centres ensure that patients receive the treatment that is most appropriate for their needs, avoiding a hospital admission if at all possible.
Self management
Referral management centres ensure that patients are kept informed each step of the way, reminded of their appointments and given a point of contact for any questions or concerns. Ongoing support and information throughout the referral process enables patients to remain in control of their own care pathway.
Planning
The referral management centre captures details of the demand for hospital and community care services and monitors demand against available capacity. This information is reported regularly to commissioners, assisting them to plan and implement the most cost effective and appropriate treatment pathways and services for patients in their local area.