South East Coast Health Referral Management Service (Hermes)

Who commissioned the service and why?

In October 2009, NHS East Sussex Downs and Weald, NHS Brighton and Hove, and NHS Hastings and Rother commissioned Harmoni to replace the Single Telephone Access Number (STAN) service.

The overall aim of the service was to improve the referral process for patients by supporting GPs, paramedic practitioners and other health professionals to make the referral arrangements for patients who require urgent health services.

In response to this, Harmoni established the Hermes service. One of the key objectives of the service was to increase the number of referrals to community health services.

Overview of Hermes

Hermes provides a telephone triage service for GPs and healthcare professionals, staffed by a multi-skilled call centre team of nurses and co-ordinators. It manages all unscheduled care (excluding mental health) and provides cover for 750,000 patients.

Hermes helps GPs and healthcare professionals transfer patients quickly to appropriate community services, and access useful information that will inform the future planning of patient care.

Hermes ensures the patient receives the right care in the right place for them. This may include treatment at the Medical Assessment Unit (MAU) or Acute Medical Unit (AMU), or where possible via quick access to community health and social care services.

The Hermes team manage every step of the referral process including patient transport, liaising with referring GPs to agree the most appropriate urgent care pathway for a patient, and confirming with the referrer that the patient has been transferred.

The service is open 8 a.m. – 10 p.m. seven days a week and receives between 1,500 and 2,000 inbound calls per month.

Outcomes

Hermes collects high quality activity data about referral patterns and service usage.

Community schemes such as re-enablement beds and the management of I.V. treatment at home are now available to patients in all three PCT areas. In addition to this, a Rapid Response Service went live in December 2010 for NHS Brighton and Hove enabling patients to be seen in their own home within two hours of the initial call. These services have been introduced due to feedback from the Hermes service.

Benefits to Commissioners

Through frequent engagement with commissioners and other healthcare providers and a flexible IT system, Hermes stays up-to-date with the constantly evolving healthcare environment.

Hermes enables locum GPs access to information on community services and referral pathways they may not be familiar with, especially when working outside of their area.

Hermes is led by clinicians who have an advanced understanding of the community services available, therefore ensuring patients receive the right care in the right place.

Benefits to Patients

Hermes is a clinician-to-clinician service where a good medical history of the patient must be provided. This helps to identify the most appropriate service for the patient's needs.

Calls to patients from Hermes co-ordinators are audited each month to ensure patient care is of the highest standard. Scores achieved from November 2009 to October 2010 were between 97% and 99% and demonstrate a consistent, high-quality service.

Hermes removes the bureaucracy of the referral process which allows GPs to spend more face-to-face time with their patients.