Endocrine Abstracts

Background: Nationally, there has been a concerted drive to utilise technology to support the provision and delivery of specialist services. Within our local area, both secondary care and 95% of GP surgeries utilise the Systm-One electronic health care record. Since October 2016, we have been providing a local Endocrine E-consultation service. A GP requiring advice, rather than referring the patient to the hospital would (after obtaining patient consent), share their record, tasking the specialist with a request for specific advice. The specialist in turn, after perusing the patients record provides appropriate advice and records this within the electronic record. The perceived benefit was that it would facilitate advice in a timely manner and reduce unnecessary referrals to hospital outpatients impacting positively on outpatient capacity. This audit was undertaken to assess workload, response-time and conversion to hospital face-to-face appointments. Information obtained was compared to income/expenditure assessing the cost-effectiveness of the service and other resulting benefits.

Results: During the audit period (Oct 2017-April 2018), 955 e-consultations received for Endocrine Advice. Average 36 per week. The ward-consultant was allocated 3 hours per week for this. Mean response time was 1 day, Average 1.77, Range 1–17. 212 (24%) e-Consultations had subsequent New Face-to-Face Endocrine outpatient appointments. The cost-savings to primary care from saved appointments was £69980 for the period. The trust accrued savings of £1151. Other benefits included:

• Advice provided to GPs/Practice nurse in advance of hospital appointments, saving time and additional follow-up impacting on referral-to-treatment time.

• Allowing patients in secondary care to be discharged with recourse to future e-consultation advice as needed without needing further appointments.

• Avoiding unnecessary tests by GPs.

• GP education with links and documents signposted

• Fully auditable advice provided, embedded in the patient record (good clinical governance).