SLIGO GENERAL HOSPITAL Outpatient Department Management Policy Information for General Practitioners. Sligo General Hospital Mission Statement

Transcription

1 SLIGO GENERAL HOSPITAL Outpatient Department Management Policy Information for General Practitioners Sligo General Hospital Mission Statement Sligo General Hospital is committed to the delivery of a high quality, patient-centred service in a safe, equitable and efficient manner. We recognise and value the contribution of each staff member and endeavour to support them in their ongoing development. Issued April 2009

2 Introduction This document sets out the updated policy used to manage the delivery of Consultant led Outpatient Services at Sligo General Hospital, as it relates to General Practitioner Services. Referral GPs should use the standardised OPD Referral Form (Appendix 1) in respect of each referral. Forms are available at All data requested should be included. Requirements for interpreter services should be advised. An Explanatory Note is included at Appendix 2 detailing the importance of key data fields: to allow identification of previous medical records i.e. previous name, PCN / Hospital Number; Date of Birth; to facilitate contact re appointments i.e. full postal address, telephone and mobile phone numbers; and to ensure availability of an interpreter at the scheduled appointment time, if required, i.e. interpreter required. Details re relevant social history are also important to facilitate discharge planning. Referral letters should be addressed to the Appointments Office, Level 1, Sligo General Hospital or can be sent via secure to: opdaptssgh@hse.ie. Urgent Referrals can also be faxed following discussion with the Consultant / Registrar and in line with SGH fax policy i.e. fax to be preceded by a telephone call to the relevant department to ensure recipient is available at fax machine to receive fax and to confirm receipt of same. GPs can contact the Consultant or Registrar by phone to ensure that very urgent referrals are triaged as a priority. (See attached contact details) A list of special interest areas together with waiting time information by Consultant and changes such as consultants retiring or new consultants and specialties being introduced is available via the Hospital Website to facilitate GPs in selecting the appropriate consultant with the shortest waiting list On receipt, if the OPD Referral Form is illegible and or incomplete in the case of an Urgent Referral the GP will be contacted by phone and details requested. If there are clinical details involved they will be obtained by a Clinician or respective Medical Secretary. If the referral is non-urgent a copy of the referral will be sent back to the GP with an Incomplete/Illegible OPD Referral form attached to the referral (Appendix 3). Referral Allocation and Registration Referrals will be allocated to the named Consultant s Waiting List provided this referral does not disadvantage the patient waiting time If the referral is not to a named consultant (Dear Doctor) the policy will be to allocate the referral to the consultant with the shortest waiting list for the required service Where a consultant has a particular interest in a sub-specialty and a waiting list specifically for this specialty, Dear Doctor letters will be allocated to that waiting list The named consultant on a referral cannot refuse to see a patient for a new referral on the basis that the patient has previously been seen by a different consultant within the specialty Immediately following the receipt of a referral, referrals will be registered as Unauthorised on the Consultants Waiting List on the Hospital Information System (IPMS) and sent to the Consultant for triage When a patient is on a consultants waiting list and when a referral is received for either the same or separate clinical presentation the referral letter is again referred to the consultant for triage re-review Every referral registration will be checked to ensure that the patient has not been referred to another consultant within the specialty for the same condition. Where this does occur the GP(s) will be contacted by the Appointment Staff to request clarification. Only one of the referrals will be maintained on the Waiting List.

3 Referral Triage A patient will not be in a clinically prioritised queue until the consultant has read and triaged the referral letter All referral letters will be triaged by the consultant named on the letter or a designated consultant within 10 working days If a consultant considers that a patient has been inappropriately referred or should have visited some other specialist, he or she will liaise with the patient s GP 3 levels of clinical priority will be used - Urgent, Soon and Routine Urgent priorities will have a clinic date or time frame specified on the referral letter by the Consultant. They will be seen as soon as possible within a maximum of 2 weeks Soon and Routine priorities will be seen based on priority and chronological order only. Soons will be seen in < 12 weeks or in line with appropriate guidelines for respective cases as they exist. Routines will be seen in the time sequence referral letters were added to the waiting list Within 2 working days of receipt of the triaged referral letter from Consultants the referral will be authorised on the Hospital Information System Referral Acknowledgement Patient referral acknowledgements (Appendix 4) will be sent within 2 working days of the referral being authorised to patients who are not being sent an appointment immediately In due course it is planned to make a bi-monthly status report available to GPs re the waiting list status of their respective patients Appointment Allocation Every patient will have a specific individual appointment time Patients will be offered a written appointment date with at least two weeks notice (14 calendar days) In the case of urgent referrals the patient will be offered an appointment at short notice that reflects the level of urgency. The patient will be contacted by phone if the appointment is within 5 days Where a patient requests to see a consultant other than the one specified by the GP or the Hospital in the case of Dear Doctor referrals, they will be facilitated whenever possible Where a patient requests to attend for a reason other than that stated on the referral letter, they will be informed that this is not possible as consultations can only be offered for the reasons stated on the referral Patients have a responsibility to keep their appointments and to give 24 hours notice if unable to attend provided the hospital has given them reasonable notice of the appointment date Cross-referral during out-patient care will be based on clinical need and the patients GP will be consulted or informed of such a referral When a consultant takes any action that results in a patient no longer requiring an Out-patient appointment, including being aware of a patient opting for private treatment, it is the responsibility of the consultant to inform the OPD Appointments Office and the patient s GP so that the patient can be removed from the waiting list. Patient Deferral A patient deferral CNA (cannot attend) in respect of first (new) appointments and subsequent (review) appointments occurs when the patient requests that an existing appointment date or the offer of an appointment date be moved to a date in the future. A patient is allowed defer twice in succession providing that the maximum total deferral time is less than1 year. When a patient attempts to defer a third time in succession, the request is treated as follows: For first (new) appointments or where the patient already had a new appointment which they deferred twice, the patient will be informed that if they cannot attend on the date offered, their GP and the consultant will be notified and they will be removed from the Waiting List

4 If the patient already had a review appointment which they deferred twice, the patient will be informed that if they cannot attend on the date offered, the consultant will be notified and that the consultant will discharge the patient back to their GP. Cancellations A cancelled appointment is an appointment that has been offered to a patient and the time or date is changed by the service Every effort will be made to ensure that cancellations do not occur, however when this is necessary, the service will provide a new appointment as close as reasonably possible to the original appointment date. Clinic Management Patients will be seen by a Consultant at least once in every 3 OPD appointments and discharged if appropriate. Patients will be seen at the time specified on their appointment letter, the target is that patients that register on time will be seen within 30 minutes of their appointment times 1. Where the patient registers ahead of the appointment time they will be informed that they will be called at their appointment time. 2. Where the patient registers after their appointment time they will be informed that they will be seen as early as time allows without disrupting the appointment times of other patients Patients will be informed by both clinicians and nursing when leaving the clinic to visit the OPD reception before leaving the hospital The practice of telling patients at clinics to come back for a further appointment if they feel the need will be eliminated and clinicians will specifically state to patients that if they feel they need further treatment after being discharged they should contact their GP. DNA s (Did Not Attend) A DNA is defined as A new or review patient that has been issued with an appointment but has failed to attend the clinic or did not respond to correspondence issued via a Partial Booking process (No Response) or a review patient that rang in and cancelled themselves from the clinic and did not request a further booking (Self Discharge). The DNA policy is that every patient will be allowed a maximum of 2 DNA s in succession and will then be discharged back to their GP The Consultant may veto this policy and offer further appointments where there are clear clinical risks or other risks (e.g. vulnerable patient). On the first DNA: - The patient will be offered another appointment - The Consultant will write to the referring clinician outlining that the patient did not attend and highlighting any concerns that the consultant has around non attendance. The letter will ask the GP Practice to confirm the patient s contact details back to the Appointments Office. On the second DNA: - The patient will be discharged on the Hospital Information System - A letter indicating the reason for the discharge will be sent to the referring clinician by the consultant. The letter will highlight any concerns that the Consultant has around non attendance. The letter will state that the patient will be re-instated at the referring clinician s request. - A letter will be sent to the patient/gp stating that they are discharged and the reason why and pointing out that they should go back to their GP for further care.

5 Appendix 1

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7 OPD Referral Form Data Field Appendix 2 OPD Referral Form Explanatory Note Reason For / Purpose of Collection Previous Name Required to facilitate identification of previous medical records. It is used when the patient s hospital number (pcn) is not available. The previous name is then used to search for and identify records that may exist in a previous name PCN / Hospital Number Used to identify previous medical records and for current admission / records Patient PPSN Uniquely identifies an individual and used to identify / confirm past medical records Telephone No Required to facilitate contact re short notice clinic appointments Mobile Phone No Required to facilitate contact between 9am 5pm if not at landline number, for contact re appointments at short notice and to facilitate text reminders re appointments (For introduction in 2009) Interpreter Required (For non English speaking patients) Language (Please specify) Identifies the need for the services of an interpreter to support the consultation process and facilitates the necessary arrangements to ensure that such services are available at the scheduled appointment time Date Identifies the timing of the request / referral Previous Consultant Identifies if the individual being referred has previously attended a Consultant at this hospital with his / her presenting complaint Specify Consultant if relevant Identifies the consultant requested to see the patient by the GP / patient. If no consultant name is specified the referral is regarded as a Dear Doctor letter and will be allocated to the consultant with the shortest waiting list for the required service Relevant Social History Identifies aspects of the individuals social history of relevance to the current / presenting complaint / likely to impact on its outcome / the individual s discharge plan and ongoing management

8 Incomplete / Illegible OPD Referral Appendix 3 Outpatient Appointment Office Address Line 1 Address Line 2 Address Line 3 Re: Your Outpatient Referral in respect of: Dear Doctor, Date: I return your Outpatient referral in respect of the above named patient. A copy of the original referral is attached. We are unable to process the referral because the following details are incomplete / illegible Name Address Date of Birth Hospital Number / Healthcare Record Number Complaint Description / Service Request Other Please update the referral and return it to this office. Please ensure that future referrals contain all the relevant information, your co-operation in this regard will help us to ensure a more efficient and responsive service for patients. If you have any related queries, please contact Ext Thank you. Out Patients Appointment Office

9 Appendix 4 Acknowledgement Letter Date «PatientForename» «PatientSurname» «PatientAddressLine1» «PatientAddressLine2» PCN:«PatientID» DOB:«PatientDateOfBirth» PPSN: Contact Number: RE: Outpatient Referral Dear «PatientForename» «PatientSurname» We wish to confirm that we have received a referral from your GP «GPTitle» «GPSurname», on the «ReferralDate» for the «ReferredByClinicianSpecialty». Your referral has been prioritised as «ReferralPriority» and has been listed on «ReferredToClinician» Outpatient Waiting List. Please note that patients are given appointments based on their clinical priority, which is decided by the Consultant on reviewing the referral letter sent in by your GP. If your condition changes while you are waiting for an appointment please contact your GP. If you no longer require a consultation please call us on «ReferredToClinician» appointment Secretary at xxxx between the hours of 9am-5pm Monday to Friday, which will allow us to offer this service to another patient. If any of the information above is incorrect please contact «ReferredToClinician» Secretary at xxxx Yours sincerely Out Patient Appointment Office

10 Consultant Contact Details are valid as of April For further updates see Consultant Staff and Special Interest Contact Details In accordance with hospital policy re the faxing of patient identifiable information, please precede all faxes with a phone call to ensure recipient is available to receive fax and to confirm receipt of same Specialty Consultant Name Special Interest Phone No Fax No Emergency Medicine Dr Kieran Cunningham Mr Fergal Hickey Paediatric Emergency Medicine, Injury Prevention Resuscitation, Sports and Soft Tissue Medicine Dr Michael Sweeney Mr Marcus Choo Extn ENT Mr Niall Considine Mr Nash Patil Rhinology, Otology Audiology Haematology Dr Andrew Hodgson Benign & Malignant Haematology, Transfusion Coagulation Extn Dr John Doherty Geriatric Medicine Dr Paula Hickey Geriatric Medicine Dr Marcus Kennedy Respiratory Medicine Dr Wilma Lourens Diabetic Extn Dr Michael Martin Medical Oncology Medicine Dr Kevin Murphy Neurology Dr Donal Murray Cardiology Dr Catherine McHugh Endocrinology Dr Dermot Mc Kenna Dermatology Extn Dr Austin Stack Nephrology Dr Kevin Walsh Gastroenterology Dr W Dinsmore Genito Urinary Medicine N/A Dr Vincent Tormey Immunology extn

11 In accordance with hospital policy re the faxing of patient identifiable information, please precede all faxes with a phone call to ensure recipient is available to receive fax and to confirm receipt of same Specialty Consultant Name Special Interest Phone No Fax No Obstetrics / Gynaecology Ophthalmology Dr Uta Maria Irsigler Dr Heather Langan Dr Raouf Sallam Dr Mohammed Abdel-Hamid Mr Paul Mullaney Ms Shauna Quinn Paediatric Ophthalmology, Cataract Surgery Medical Retina and Glaucoma Extn Mr Bill Gaine Paediatrics Orthopaedic Dept Mr Satish Kutty Paediatrics, Hip, knee, ankle and foot surgery Mr Andrew Macey Hands / Limbs Dr Dara Gallagher Community Child Health Extn Dr John Gleeson Paediatric Dept Dr Hilary Greaney Community Child Health Dr Nath Tummulura Cystic Fibrosis, Diabetes and Neonates Palliative Care Dr Cathryn Bogan Pain Management Dr Therese O Connor Pain Management Extn Rheumatology Mr Bryan Whelan Mr I Ahmed Extn Mr Martin Caldwell Gastrointestinal Surgery Surgery Mr Peter Morrison Mr Hassanein Mr Tim O Hanrahan Surgical gastroenterology, surgical oncology, nutrition, thyroid disease/surgery Urology