Clarification on the process for referrals

Monday 16th April, 2018

We have received a number of emails in relation to whether the CCG has referral management schemes in place, where GPs referrals are checked by a second group of health professionals before they are processed.

We would like to assure everyone that there is not a scheme in place in Coastal West Sussex where a patient’s referral is checked by a third party to make a decision on whether the referral goes forward or not.

We recognise the skills and expertise of our GPs, and the relationship they have with their patients, which all contribute to their judgement about whether a referral is necessary for that individual patient. We have no intention to override that or put measures in place that add an extra level of bureaucracy for a referral to be made for our patients.

Patient Care Navigators

You may have heard about a scheme we do have in place called ‘Patient Care Navigators’. These are a team of experienced administrators working across Coastal West Sussex to support GP practices with the paperwork and process of making a referral. These are not clinicians who consider the referral in terms of its appropriateness, but a skilled admin team who help to make the process as smooth as possible for patients and GP practices.

After you have seen your GP, and together you have agreed that you need to be referred for specialist treatment, your GP practice will forward your referral to the team of Patient Care Navigators at the CCG who, using the NHS e-Referral System (formerly Choose and Book) will help you to make an informed choice about where to go for your treatment. They will then help to complete the paperwork and make the booking on the online system.

In accordance with the NHS Constitution, you have the right to choose when and where you wish to be treated and in a timely manner.

In terms of how you contact the team, your GP will provide you with a booking card after discussing the referral with you, and a telephone number for you to contact the team. You are then asked to contact the Patient Care Navigators five days after seeing your GP so they can work with you to book your appointment.

Information will only be shared when you have agreed with your GP that a referral is the best course of action.

Following discussion with you, the Patient Care Navigators will send your referral on to the hospital or community provider of your choice, who will then contact you to confirm your appointment. If you then have any questions or concerns about your referral or appointment with the hospital or community service, you can contact the Patient Care Navigators and they will have the time and information to be able to help.

The aim of the Patient Care Navigators is to provide GPs with the support that they need to deliver the best care in the long term; it frees up their time from chasing queries about hospital or community appointments and acting as a conduit for these questions, so that they can focus on providing the best possible care directly to patients. In addition, the team give patients a direct contact for them to go to with any queries about the organisation of their next appointment so that this can be arranged as smoothly as possible for the patient.

We hope we have been able to provide reassurance that we don’t have a referral management office in place that is doing anything to undermine the relationship between a patient and their GP, or a GP’s expert knowledge.