Sunderland Teaching Primary Care Trust (TPCT) faced the common problem of long waiting times for hospital dermatology appointments, but also realised it had an asset in the shape of three local GPs with particular expertise in the specialty.

Head of IM&T, Dave Shovlin takes up the story: “The GPs, together with the lead for Dermatology Services at the TPCT, decided they wanted a technological solution, which would enable them to refer patients to GPs with a special interest in dermatology rather than secondary care with possible long waiting lists.

A browser-based application which could be accessed in real time by authorised users across the trust offered the potential for ease of use and substantial time savings. The TPCT was already using this type of application to support data collection in the areas of referral information, personal medical service monitoring information and a smoking cessation programme.

In addition the TPCT have invested in a modern communications infrastructure by installing a wide area network delivering 10Mb of bandwidth to each practice. This provided the robust, secure connections between practices needed to make a referral system quick and reliable. Utilising SSL encryption technology, the network provides a fast secure medium for the system.

The application developed by Graphnet enables GPs to log onto the referral system via their PC and book a dermatology appointment at a convenient time for the patient. A confirmation letter is sent automatically to the patient who can phone in to change the appointment if necessary. The referring GP eventually receives a summary about the diagnosis and treatment.

XML technology provided a critical element of the solution: the application exploits XML’s facility for creating the seamless, real time communication across different GP systems needed to make the booking system work.

In phase two of the project, the intention is to add graphical data to the referral letter and where practicable, introduce electronic discharge summaries integrated into the patients’ electronic records at their GPs’ practices.

”There are substantial savings on waiting time and a fairly substantial saving on costs,” said Mr Shovlin. “The main benefit though is the dramatic improvement in patient choice and involvement in the referral process. Patients, at the point of consultation with their GP, can now choose who they are referred to, on what day and at what time”. Although the project currently focuses on dermatology services, the system has been developed flexibly to include all GPs and services in any specialty that may develop in the future.

Key points:

• Enables GPs across a PCT to use their specialist expertise within the locality
• Offers patients a choice of appointment times and offers a choice between different GPs
• Cuts waiting times in areas and specialties where there are long waits for hospital outpatient consultation and treatment
• Saves money – a GP consultation costs
significantly less than a hospital referral
• Scalable – the application can be developed easily to take in other specialties as and when the TPCT can organise the services