Access to Advice and Guidance

Advice and Guidance (A&G) enables GPs to directly contact specialist consultants in secondary care and work collaboratively to ensure patients receive the right care in the right place prior to a referral being made.

A number of tools are currently available on the market to provide this service, with a national CQUIN in place to kick-start this approach. Clinicians in Salford are currently piloting the use of advice and guidance (A&G) tools to enable rapid, multi-way interaction between clinicians in different settings. Our priority is for A&G to simplify the process of communication, enable shared decision making and provide a better service to patients.

Advice and Guidance has currently been rolled out across Salford Royal Foundation Trust’s Gastroenterology, Respiratory and Cardiology departments, with more specialties to be added soon. More information regarding example cases can be accessed here.

The Pilot

The pilot aims to reduce the number of first outpatient appointments and follow up outpatient appointments.  The pilot has a number of objectives including;

  • To provide a simple easy-to-use system for GPs looking for specialist advice on treatment options or whether specialist treatment is required
  • To explore the potential to improve patient journeys by reducing the number of people discharged from outpatients without any treatment and reduce short stay admissions
  • To free up consultancy capacity to support delivery of 18 week Refer to Treat Target
  • To improve GP/consultant dialogue and reduce variation in methods for accessing advice in a standardised format to improve safety

As part of the pilot, a Standard Operating Procedure has been co-designed and drafted with input from clinicians in primary and secondary care.

Data collected from the cardiology department demonstrated that on average it took 8 minutes to respond to each A&G request from the time it was opened, a response submitted and closed, with a high proportion of requests able to be dealt with by the A&G process, avoiding unnecessary referrals and providing quicker treatment plans for patients.

You can read the full 12 month evaluation report here.