Endocrine Abstracts

Background: Electronic endocrinology advice and Guidance (e-Endo A&G) via NHS e-Referral Service was introduced at University Hospitals of Leicester NHS Trust (UHL) in March 2017 to address General Practitioners’ (GP) non-urgent endocrinology clinical concerns. Primary aims of the service, was to prevent inappropriate outpatient visits, avoid acute admissions and reducing length of time in resolution of queries.

Objectives: To retrospectively evaluate utility of e-Endo A&G for 12-month period, and to estimate whether the service is compliant with National CQUIN of >80% questions answered within 48-hours.

Methodology: Retrospective analysis of all UHL’s e-Endo A&G queries (n=366) from Leicestershire GPs from April 2017 to March 2018 was undertaken.

Results: n=366; 96% answered by Consultants; 4% by Registrars. Referral composition: Thyroid-38%; General Endocrine-18%; Gonads-10%; Bone-9%; Gynae-Endo-8%; Pituitary-6%; Parathyroid-6%; Adrenal-5%. Average response time <48-hours-94% (343/366), against CQUIN target of >80%. <24-hours-83% (303/366). 65% (238/366) queries were resolved preventing an hospital episode. 35% (128/366) resulted in clinic visit, following appropriate workup and/or treatment initiation. Furthermore, at £25 per query, £9,150 income was generated for the Trust.

Discussion: e-Endo A&G is a clinical governance compliant, time-efficient system resulting in reduction in clinic visits/admissions by 65%. It is recommended for trusts to avail following benefits:

1) For patients:

a) Patients’ speciality concerns resolved within 48-hours.

b) Shorter clinic waiting times if outpatient visits necessary.

c) Prevents travelling to secondary care centres.

1) For GPs:

i) Rapid access of Endocrine expertise for non-urgent clinical queries.

ii) No loss or delay in communication.

iii) Cost saving measure.

1) For Endocrinology department:

i) Prevents inappropriate outpatient visits.

ii) Shorter waiting times.

iii) Priority patients seen earlier

iv) Registrar training opportunities.

1) For Trust:

i) Clinical Governance compliant (audit trail and medico legal)

ii) Income generation

iii) Potentially fewer complaints handling.