How NHS referral optimisation systems are helping to cut waiting lists

Elective care under pressure

Covid-19 created an enormous backlog in elective care. As of May 2023, 7.3 million people were waiting for tests or treatment and the government is investing £8 billon over three years to expand capacity. The aim is to increase the number of checks and procedures, with the NHS delivery plan calling for better use of technology to help.

Inefficient referral processes

Referring patients to secondary care can be cumbersome for everyone involved. GPs first have to select the right pathway from among myriad options, create the request and add supporting documents to the national e-RS system. If their local systems don’t connect, they may need to download relevant imagery from one system, print it out then scan it in to the other.

The consultants who review the referrals have a similarly disjointed experience. They will need to:

• log in to e-RS to locate the referrals for their specialism
• log in to each patient’s electronic record separately to see their history
• download scans to the hard drive to be able to view them
• make their decision, for example selecting a routine or urgent appointment

Clinician time is at a premium, yet they’re stuck doing admin when they’d rather be seeing patients.

Affecting non-clinical staff too

Once consultants have made their decision, the admin doesn’t stop. Staff at the hospital will need to download the details of each decision, manually update the electronic patient record and book the patient in to the right clinic.

And if the referral is rejected, for example because the patient needs to see a different specialist, the whole process starts again. Every manual step adds unnecessary delay and means patients wait longer for their appointments.

Advanced NHS referral optimisation

Used by 50 hospitals and 500 GP practices, NEC Rego streamlines the referral process from start to finish. It removes the need for GPs and consultants to switch between systems and it uses intelligent workflow and AI to help clinicians select the right pathway first time.

Rego auto-populates data fields, leading to fewer errors and less time spent on manual entry. It also validates referrals as information is added, guiding GPs to the right pathway in just 90 seconds. Hospitals using Rego then get a single view of referrals, medical history and demographic information along with a built-in image viewer. And once a decision is made, the full details are transferred to the electronic patient record automatically.

It helps consultants to make decisions faster, reduces booking delays and gives managers a clear view of performance so they can identify any bottlenecks.

Streamlining advice and guidance

Rego’s ‘Advice and Guidance’ module also reduces the number of rejected referrals by creating a secure and efficient route to get advice from a specialist. GPs prepare the referral, attach relevant scans or imagery and request reviews. Consultants then use Rego’s secure messaging service to liaise with the practice and either accept the referral or re-route it, for example to a different specialism.

With all the messages stored in Rego, there’s no need to use a separate email system and the hospital won’t have to bounce the referral back to the GP. It means faster triage and more time for clinicians to spend with patients.

Proven in primary and secondary care

Hillingdon hospital uses NEC Rego for all routine referrals and their consultants have returned 46% of cases back to primary care. It’s freed up much-needed space in clinics and meant less worry for patients. Ipswich hospital also uses it in Dermatology, where the Advice and Guidance module has reduced pressure on the two week wait pathway by enabling 60% of cases to be downgraded to routine. It means that patients who may be most at risk get seen sooner.

With the government aiming for 30% more elective activity by March 2025 than before the pandemic, making the referral process more efficient is a good way to start.