Developing a Community Based Clinical Assessment Service

1
Developing a Community BasedClinical Assessment
Service

• Jane Harper-Smith
• 24th November 2005

2
Strategic Context

• National Waiting Time Targets lt 18 weeks
• Patient Choice
• Choose and Book
• Payment by Results
• Practice Based Commissioning
• Achieving greater quality and value

3
Utilising Capacity across the Whole Health
Economy
4
Referral Pathway for the Clinical Assessment
Service
5
Referral Pathway

• Patient seen by GP given leaflet
• Referral template faxed CAS within 24hrs
• Protocol assessment within 4 working days
• Patient phones after 5 working days
• Informed of type of appt (Primary/Sec)
• Offered Choice of appointment
• Fully booked appointments- 4 weeks

6
Benefits for Patients

• Aware of process from time of referral
• Appointment agreed within one week
• Choice of locations in primary care
• Fully Booked Appointments
• Reduced waiting time for appointment
• Many more appointments closer to home

7
Benefits for Clinicians

• Primary Care/GPs
• Awareness of range of Services in primary Care
• Reduced Waiting Time for Patients
• Better Value for Money
• Choice and Booking provided by CAS
• Tracking of all referrals performed by CAS
• Secondary Care/Consultants
• Reduced inappropriate referrals
• Increased Surgical Conversion Rate
• Reduced DNAs/Cancellations
• Improved Capacity in clinics

8
Challenges

• Business Planning/Invest to Save
• Publicity of Clinical Assessment Service
• Performance manage, educate and learn.
• Rollout of other Specialities
• Location/function of CAS (medium/ long term)
• Ensuring complete integration with all other
  projects ie Choose and Book.
• Delivering the benefits realisation for everyone

9
Early Outcomes

• 100 of routine GP referrals screened.
• 72 of all referrals seen within primary care
  settings
• Lower Waiting Times- 4 weeks average
• Reduced DNA Rate of 7 (v 18)
• Reduced follow up rate (61.5)
• Net tariff saving of 220k inc set up costs