The following real-life case studies show the impact that the new hub operating model is having across a range of clinical scenarios. These are supported by a full evaluation of the hub project which will be published shortly.

Case Study 1: Speedy access to urgent medical advice

In mid-December 2022, a concerned parent submitted an eConsult at 6.44am on Monday morning seeking advice for their child who has a sore throat. This was at the height of the Strep A outbreak and shortly before Christmas when practice capacity is often most strained. Before the new operating model was in place, the parent would have been faced with the challenge of getting through to their practice by phone as soon as the surgery opened – and may then have had difficulty securing a same-day appointment due to the pressure on services.

Under the new operating model, the eHub team received the eConsult first thing and had triaged the request by 8.57am. They contacted the parent to offer an appointment by mid-morning, and the child is seen by an Advanced Nurse Practitioner at their local practice for later in the afternoon. In under 12 hours, the patient has been triaged, booked into an appropriate clinical service and given the necessary medical advice and treatment at the busiest time of the week during one of the busiest periods of the year.

Case Study 2: Supporting ‘right care, right place, right person’ principles

Late afternoon in early 2023, a patient puts in an eConsult request for an elbow injury. The eHub team triages the request within the hour and confirms that the case is appropriate for a referral to the First Contact Physiotherapist service. A Care Coordinator then contacts the patient and makes a telephone appointment for one week later.

This example reflects the role that the Online Consultation service plays in supporting access to a wider range of PCN services. The First Contact Physiotherapist is available for telephone triage appointments which can be booked directly by practices as well as by the Hub team – and in this case, the patient was triaged, contacted and given an appointment within an hour of submitting their online request.

Case study 3: Maintaining fast response times during periods of peak demand

According to the data collected over the last year, Tuesday 11 April 2023 represented the busiest day for eConsults, with over 250 clinical requests being submitted across the Folkestone, Hythe and Rural area.

One of these requests was from a patient with a rash or skin problem and came into the team at 9.37am. By 9.42am this had been triaged and a decision to offer a face-to-face appointment was made. By 11.05am, the Care Coordinator had spoken to the patient and booked him in for an appointment at his local surgery.

The fact that a patient could be triaged, contacted and given an appointment within just two hours of submitting an eConsult request, on the busiest day of the year, shows the speed and efficiency of the hub is not hindered by volume. It also demonstrates the scale of workload that is being lifted from individual practices, thereby supporting their resilience at the busiest times too.

“As a member of the Patient Participation Group (PPG) for Folkestone Hythe & Rural PCN, I’ve seen the difference the new operating model has made for patients. It is offering a more consistent level of care across the seven practices, while the additional services delivered by the hub mean that patients are being seen by the right professional for them.”

Caroline

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