Aims The Royal College standards ‘Facing the future: Together for child health’ outlined ways to improve communication between primary healthcare professionals (GPs) and paediatricians. Standards 1 and 2 recommend that GPs have immediate telephone access to a consultant paediatrician and access to urgent review within 24 hours. Previously, our advice line was available for 1 hour on weekdays but has been extended to 9am– 9pm on weekdays and 9am–5pm on weekends. Our aims were to quantify the use of this extended advice line and the impact on the paediatric service in a local district general hospital (DGH), over 12 months. We present our interim findings.
Methods*Data was collected on calls received between April– November 2016. The date, time, number of calls, the GP surgeries using the service, the query and outcome were recorded. The extended hours have been advertised via Clinical Commissioning Group (CCG) meetings and to each GP practice.
Results 312 calls were received during the study period. 72 GP surgeries accessed the service. 99.7% of calls were received Monday-Friday, with 51% on Thursdays and Fridays. 56.4% of calls required advice and no follow-up. 15% of calls required routine outpatient referral, 8% required urgent outpatient referral and 3.8% required assessment on the day. Only 0.3% required consultant review within 24 hours. 32% of calls resulted in outpatient avoidance and 8.3% in admissions avoidance. Calls have increased monthly from 36 in April to 78 in November.
Conclusion The GP hotline has reduced outpatient referrals and acute admissions. Only one call required consultant assessment within 24 hours, questioning the role of rapid access clinics. Consultants doing clinical work found carrying the telephone disruptive to consultations so a separate telephone hotline has been required on weekdays to allow the telephone to be answered immediately. Out-of-hours calls can be covered by the on-call consultant. Currently most calls are still over lunchtime Monday-Friday but with awareness the number and distribution of calls are increasing. If the extended hours are to be continued, the sustainability of this service will require additional funding and workforce planning.
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