Delivering the 18 Weeks Referral to Treatment Standard Output Report

also been recognised that there may be regional approaches that could be initiatedto overcome variation in the nature of referrals to secondary care.MythbustingFact: Demand into secondary care is not a given: it can be driven down. Anysecondary care practitioner has the right to refer a patient back to the referrer e.g. ifthe procedure would be more appropriately carried out within the primary orcommunity care setting, or if alternative care pathways can be initiated.Effective Referral ManagementThere is likely to be further scope for shifting the balance of care by proactivelytriaging patients and reinforcing appropriateness of patient flows. An example ofgood practice in the area of referral management and triage is Greater Glasgow andClyde’s Referral Hub within their Dental Hospital.Sharing Good Practice - Glasgow Dental Hospital (GDH)In 2007, an electronic referral pilot was commenced for referring patients from theGeneral Dental Service (GDS) to acute Dental Services. The aspiration is that allreferrals to acute salaried and community dental services are made to a virtualreferral centre for triage to the most appropriate location. The key benefit of this isthat referrers know the referral has been received. The recipients are provided withcomprehensive information that allows efficient triage. Mandatory fields must becompleted, thereby ensuring relevant demographic and clinical information isincluded.To date all specialties can now be referred to acute services using the electronicreferral. 50 GDS and Salaried and Community Dental Service (SCDS) locations canuse electronic referrals with a further 50 poised to go live in early 2011. In addition,daily vetting has now been established for paper and electronic referrals whichensures prompt appointing to the appropriate clinic.Training is scheduled for clinicians and health records staff for electronic triage. Thiswill have additional benefits for GDS, as the referrer will be able to view on screenwhen the patient has been triaged and appointed to a clinic.Currently GDH are also pursuing the possibility of ensuring that SCDS locations canhave their clinics included on the acute hospital’s patient information system. Thiswill allow patients for acute services and SCDS to be referred to GDH. The referralswould then be triaged electronically to the most appropriate locations.Protocols will be developed to ensure consistency in triage. This currently is in placefor referrals to adult sedation services where all patients are referred to GlasgowDental Hospital and then triaged by a Consultant and a Salaried GDP before beingappointed (for assessment and treatment) to the most appropriate clinic. Fullinformation will be provided to referrers on which groups of patients each SCDSclinic treats. Clinic templates will be reviewed and systems for cancellation andDental Specialties Task & Finish Group – January 2011 25