Endocrine Abstracts

Since July 2005 our centre has offered an e-mail enquiry service to General Practitioners. This service was established for two reasons, firstly to create a more efficient way of dealing with clinical enquiries from primary care and secondly with a long term objective to reduce GP referral rates. The service is manned by Endocrine/Diabetes Specialist Registrars and is part of their training commitment. Compared to telephone calls it gives the registrar more chance to think through queries without distraction or interruption. There is also greater opportunity to seek advice from senior colleagues. A further advantage of this system is that it provides a measurable log of our work and a medico-legal documentation of clinical interaction. The service has now completed its third audit cycle, with analysis of 3 month periods between July–September from 2005–2007 inclusive. For the three month period analysed in 2005 there were 50 enquires. This rose to 105 in 2006 and 132 in 2007. Analysis of the 2007 data shows that thyroid function abnormalities made up 50% of the endocrine enquiries, the next most common questions regarded electrolyte disturbances (15%) then testosterone abnormalities (10%). Further analyses of the replies sent indicate that in only 10% of cases was a formal referral suggested. Our aim has been to reply to all enquires within 48hrs and this has been achieved in 80% of cases.

At present the service is free to all primary care physicians in Oxfordshire, although this is under review. With the current data, we are unable to say objectively whether the e-mail service ultimately reduces referrals to the out-patient clinics. Accordingly, we will be looking to find ways of quantifying this through further audit. We have received a number of e-mails with positive feedback and feel the service is extremely beneficial to all involved.