16.3.22 Accessing Neurology Services at UHS – Advice & Guidance and Intelligent Triage
We have been working with UHS to improve Advice and Guidance (A&G), starting with Neurology. The neurology service introduced enhanced triage for new referrals last year, helping to reduce average waiting times from 50 weeks in December 2019 to 18 weeks in April 2021. However, both GPs and UHS consultants have highlighted challenges with A&G. One of the key barriers to addressing this has been the use of two different systems in UHS, one for A&G, and one for referrals. This has resulted in capacity challenges and duplication; the A&G system is also not accessible to all clinicians and produces limited management information to inform job planning etc. Partly as a result, there have been inconsistent A&G services across the Trust, with primary care not always receiving the services they need.
To improve this, we have introduced an ‘intelligent triage’ service, extending the referral pathway for neurology to include A&G from 2 August 2021. Primary care will continue to use eRS, but all requests for Neurology will go via a single route – ‘Neurology – Intelligent Triage’ (service ID: 7948544). The separate ‘Neurology – Advice and Guidance’ route in eRS will be closed to new requests with information signposting referrers to the new service.
All requests made via Intelligent Triage will go into one system in UHS, and be reviewed by a consultant neurologist. GPs can specify if they have a particular preference for either A&G or a referral/ appointment. If no preference is stated, the consultant will manage them in the way they judge most clinically appropriate. They will take an ‘advice first’ approach, so wherever possible A&G will be offered (with or without an investigation). If the consultant feels that an outpatient appointment (virtual or face to face) or other outcome is more appropriate they will arrange this for the patient.