ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2011) 25 P68

Improving communication in clinical care: a re-audit of an Endocrinology and Diabetes GP e-mail advisory service following commissioning

Barbara Alberts, Neil Walker, Niki Karavitaki, Jonathan Levy & John Wass


Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, UK.


Introduction and aim: An e-mail based GP advisory service was launched by the authors’ centre in 2005. The PCT commissioned the service in July 2009. Enquiries are handled by specialist registrars with consultant supervision. The charge is £23/enquiry.

Pre-commissioning, annual audits demonstrated an efficient and popular service, enhancing communication links between primary and secondary/tertiary care.

We re-audited the service post-commissioning to ensure a high quality service was maintained and still widely utilised. We also added a user satisfaction survey.

Results: The number of enquiries between July 2009–July 2010 reduced to 543 compared to 701 in 2008, 501 in 2007, 400 in 2006 and 180 in 2005.

Post-commissioning the proportion of more complex and detailed enquiries increased – possibly reflecting a more cost conscious use of the service. 75.1% of e-mails dealt with endocrine problems. 13.3% with lipids and 11.6% with diabetes. Of the endocrine queries, 40.4% dealt with thyroid abnormalities, 15.4% pituitary and 14% bone. Other endocrine categories added <10% each.

Referral was suggested in 25.9% of cases, an increase from 15% in 2008, again reflecting the complexity of enquiries.

The survey response rate was 41% (41/100). 97.5% of respondents were satisfied with the clinical answers. 92.7% felt they received a timely response. 55.3% reported that the advice prevented a clinic referral.

Conclusions: The service continues to be valued and well utilised. It delivers structured, medico-legally recorded advice, at a convenient time, and has proven benefits in preventing unnecessary clinic referrals.

Future developments: The centre aims to answer 90% of queries within 2 working days. GP feedback and the nature of queries will be used to develop targeted teaching modules for GPs and trainees.

Building on the success of the E-mail advice line, the centre hopes to make use of more E-Health Technologies in the future.

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