GIRFT has produced two guides to help improve the interface between primary and secondary care, such as how referrals are made and managed, patient discharge and how different parts of the health service communicate with each other.
The guides outline principles and standards to improve processes and teamwork. They set out standardised best practice across trusts and primary care, based on existing national policy and guidance, local guidance, and expert clinical opinion.
By reviewing current practice against this guidance, it is hoped that healthcare teams can spot gaps and areas where change is needed. The aim is to encourage better collaboration between secondary and primary care and community services to streamline pathways and ensure the right patient is referred at the right time.
GIRFT is working with NHS England’s primary care team to better understand the current issues across the primary and secondary care interface. Good communication at the interface of healthcare organisations is essential to achieve the most seamless care for patients but this can be challenging when working across multiple sectors and particularly for patients with complex needs.
The Bridging the Interface guide promotes ICB-led joint working and behaviours, and outlines eight key areas for improvement to be applied across a healthcare system:
- Joint working and behaviours
- Clarity for patients on who to contact and where to go for help
- Advice and Guidance (A&G) and referrals
- Secondary care enquires
- Tests and diagnostics
- Prescribing and discharge letters
- Surgical optimisation
- Urgent and Emergency Care (UEC)
It aims to help clinical teams in primary, secondary, mental health and community services establish strong partnerships that support a smooth interface and deliver better patient flows and an enhanced experience for both the patient and clinician.
The goal is to enhance patient care, reduce emergency department pressures, cut elective waiting times, and support sustainable general practice.
The Clinical Operational Standards guide presents frameworks for clinicians working in primary care, acute care, specialty care, with the frail patient, and in the care of children and young people (CYP) to help improve performance against urgent and emergency care targets and ensure the efficient flow of patients through our hospitals.
The standards describe how staff are expected to work including the actions and responses required, and associated timeframes, to deliver optimal patient care. A key objective is to help operational teams and clinicians work together to assess whether their service is delivering the care and behaviours described in the standards.
The guide includes section on:
- Primary care standards.
- Acute care standards.
- Specialty care standards.
- Care of people with frailty.
- Care of children and young people.
It is hoped that ICBs will review the two guides with primary and secondary care colleagues in conjunction with the Red Tape Challenge recommendations to reduce bureaucracy in the NHS as part of the national 10-year heath plan, and that they will initiate changes required to increase time for clinicians to care, by reducing bureaucracy.
