Why Improving Referral Management is Essential to Meeting the 18-Week Target
NHS England’s Elective Reform Plan, published last week, sets out an ambitious goal of restoring the 18-week standard for planned treatments by March 2029.
To achieve this, the plan outlines several strategies, like expanding the use of Community Diagnostic Centres (CDCs) and surgical hubs and reducing unnecessary referrals. At the core of these strategies is the need to improve the efficiency of patient flow. And a critical part of this process begins with referrals.
How referrals are received, the quality of the information they contain, and how efficiently they are managed will play an important role in meeting the 18-week target.
The chaos of incoming referrals
Currently, the majority of referrals enter the system in a disorganised manner.
Referrals come in as paper forms, emails, faxes, disconnected digital platforms, and for many hospitals, there is no unified system. Staff must piece together information manually, often using whiteboards or Excel sheets to organise the influx. It’s inefficient, it’s time-consuming and frustrating for staff, and it delays care for patients, all contributing to the long and growing waiting lists.
Centralising all referrals can make a huge difference. Take King’s College Hospital Foundation Trust (KCH), the busiest trauma network in the UK, as an example. They were overwhelmed by a flood of tertiary referrals coming in via emails or phone calls. Managing these referrals manually and in time became unworkable.
To address this, KCH implemented Pathpoint eTrauma, a trauma management solution with powerful referral management capabilities.
The solution centralised orthopaedic trauma referrals across their network into one governed system while also including features like automated notifications and feedback to referrers. eTrauma streamlined their entire external referral process. Chaos was replaced with clarity, and efficiency improved significantly.
A centralised referral management ensures all referrals, whether from primary (achieved with e-RS integration, for example) or tertiary care, or internal referrals, are funneled into a single platform to replace disarray with structure and accelerate the patient journey through the system.
The quality of referrals
But referral management isn’t just about where referrals go; it’s also about what they contain.
Poor-quality referrals are a widespread issue, often missing the vital information needed to move patients forward. This can happen because referrers are unclear about hospital pathways or criteria.
For example, consider a referral for a suspected cancer case that is missing test results. Without this information, the referral stalls because the patient cannot be moved forward without this preliminary test, and clinicians have to chase missing details. This not only delays the patient’s care but also creates a ripple effect, holding up resources and slowing down other patients in the pathway.
Digital tools can solve this problem by ensuring all essential clinical details are included. For instance, Pathpoint Referral Management includes mandatory fields to ensure all essential information is included. It can also provide protocols and criteria for specific pathways, like patient age or specific test requirements, helping to ensure referrals move forward and patient flow is not affected.
The triaging challenge
With scattered referrals and incomplete information, triaging becomes difficult, and teams end up spending more time trying to fill in gaps rather than on care decisions.
A well-designed referral management system changes this aspect of the process as well. It doesn’t just collect referrals into one place but also improves the downstream process, such as with automatic updates for referrers, informative leaflets for patients, and even incorporating patient questionnaires to provide additional data for decision-making.
Internally, it can streamline communication between departments, reducing handover gaps. Externally, it helps keep referrers informed and patients reassured.
When triaging is intuitive and organised, healthcare teams can focus on delivering care, and patients experience fewer delays, making their journey through the system much smoother.
Achieving the 18-week target
Improving these aspects of referral management and ensuring patients enter their pathways efficiently is a necessity for hitting the 18-week target, especially as CDCs and surgical hubs shoulder more of the pathways. It solves a good chunk of the inefficiency in processes, so nailing this first step will be critical to the success of the Elective Reform Plan. And with the right tools, it is definitely within reach.
Explore how Pathpoint can help your organisation enhance referral management, improving patient pathways and supporting you in meeting the 18-week standard.
