Consultant to Consultant Referral Policy

Transcription

1 Consultant to Consultant Referral Policy Version Author Date Comments Approved by No V1.0 Mel Sims 19 January 2017 To be APPROVED Governing Body

2 Reader information Reference Document purpose COM002 This policy sets out the way in which providers will approach the management of Consultant to Consultant Referrals Version V1.0 Title Author Consultant to Consultant Referral Policy Head of Acute Contracting CCG Approval Date 19 January 2017 CCG Approving Committee Governing Body Review Date January 2020 Groups/staff Consulted Clinical Contract Board Target audience Circulation list Associated documents All staff in Acute Provider organisations Acute Providers GPs N/A Superseded documents Consultant to Consultant Referral Policy dated Sponsoring Director Director of Contract Delivery Page 2 of 6

3 Contents Page 1. Policy Statement 4 2. Introduction 4 3. Policy and Procedural Requirements Consultant to Consultant referrals within the same speciality 3.2 Inter-specialty consultant to consultant referrals 4. Due Regard 5 5. Equality Statement 5 6. Monitoring 6 7. Review Page 3 of 6

4 1. Policy Statement This policy sets out the way in which providers will approach the management of Consultant to Consultant Referrals The aim of this policy is four fold: to ensure that patients are offered choice for each different episode of care where clinically appropriate to provide care closer to home wherever possible by ensuring management of patients within primary care where appropriate to contribute to the management of secondary care capacity by ensuring only those genuinely needing secondary care receive it, and in a more timely way as part of 18 weeks pathway to still allow consultant to consultant referrals where in the patients best interest or part of a natural clinical pathway Patients should be treated for the condition for which they were referred. necessitate a referral to another colleague or another specialty. This may Incidental findings will normally be referred back to the patient s General Practitioner (GP) for management in primary care in the first instance. Incidental finidngs that are considered to be clinically urgent or are of suspected cancer should still be referred to the appropriate colleague 2. Introduction There are times when consultants in secondary care refer patients to another colleague, either within the same speciality or in another specialty, this can be within the same provider or between providers so called consultant to consultant referrals. In some circumstances which will be outlined below this is absolutely appropriate and in the patient s best interest. Clinical Commissioning Groups (CCGs) have no desire to stop such referrals, but at many other times the patient will need to be offered choice, or their problem may actually be manageable in the community. This policy which has been clinically agreed defines the above groups. Importantly since 1 April 2009 onwards, CCGs have not funded consultant to consultant referrals, except those meeting the criteria set out in this policy where the referral is judged in the patient s best interest. Any referrals outside of this policy would be subject to prior authorisation, though this would be exceptional. Any such requests should be directed to the CCG contract lead in the first instance. Any referrals made outside of this policy without prior authorisation will not be funded by CCGs Page 4 of 6

5 3. Policy and Procedural Requirements 3.1 Consultant to consultant referrals within the same speciality This policy allows consultant to consultant referrals in the same specialty for the condition for which they were referred. Where a patient requests a second opinion, they should be referred back to their GP rather than a referral being made to another consultant. 3.2 Inter-specialty consultant to consultant referrals Consultants should only refer patients to another specialty for a condition not related to the reason for the original referral if it is deemed to be clinically urgent and in the patients best interest (that is for which a delay would be detrimental to the patient s health). Inter-specialty referrals will be allowed in the following situations: a) If unrelated to original referral Existing cancer diagnosis or suspicious symptoms (2 week wait referral criteria) Clinically Urgent Referrals of frail older people at risk of falls Immuno-suppressed patients (including transplant patients) Inherited and acquired bleeding disorders (referral to/from haematology) b) Natural Pathways e.g. maxillo-facial to orthodontics etc. c) Necessary work up prior to surgery e.g. cardiology following pre-operative anaesthetic assessment d) To continue treatment for the original condition in another specialty If these criteria are not met, the patient should be referred to the GP. The clinic or discharge letter should include a request that GP consider the issue raised and the patient should be asked to see their GP. This allows patients to have choice of provider of their care where appropriate, without putting delays in the system, when to do so would be detrimental to their health. All consultant to consultant referrals should be copied in to the patient s GP when the referral is made. 4. Due Regard This policy has been reviewed in relation to having due regard to the Public Sector Equality Duty (PSED) of the Equality Act 2010 to eliminate discrimination; harassment; victimisation; to advance equality of opportunity; and foster good relations between groups. 5. Equality Statement 5.2 NHS Rushcliffe Clinical Commissioning Group (CCG) aims to design and implement policy documents that meet the diverse needs of its services, population and workforce, ensuring that none are placed at a disadvantage over others. It takes into account current UK legislative requirements, including the Equality Act 2010 and the Human Rights Act 1998, and promotes equal opportunities for all. This document has Page 5 of 6

6 been designed to ensure that no-one receives less favourable treatment due to their personal circumstances, i.e. the protected characteristics of their age, disability, sex (gender), gender reassignment, sexual orientation, marriage and civil partnership, race, religion or belief, pregnancy and maternity. Appropriate consideration has also been given to gender identify, socio-economic status, immigration status and the principles of the Human Rights Act. 5.2 In carrying out its function, NHS Rushcliffe CCG must have due regard to the Public Sector Equality Duty (PSED). This applies to all activities for which the CCG is responsible, including policy development, review and implementation 6. Monitoring This policy forms part of the service contract and therefore compliance with it will be monitored through the regular contract monitoring process. 7. Review The Consultant to Consultant Policy will be reviewed periodically every three years (or earlier if changes in circumstances require it) and will be approved by the Governing Body Page 6 of 6