Welsh e-referral plans and controversy

Wales is due to launch its own electronic referral system in the summer, with a version of the clinical communications system used in Scotland.

Informing Healthcare told EHI Primary Care that electronic referrals and clinical communications between GPs and secondary care will be managed through the Wales Clinical Communications Gateway.

The system is a version of the Scottish Care Information Gateway already used in Scotland for 97% of referrals.

A spokesperson for Informing Healthcare said Wales and Scotland were currently finalising an arrangement that will allow NHS Wales to use the SCI Gateway and allow for future collaborative developments.

Its adoption follows a proof of concept pilot in Cardiff and Vale NHS Trust, which Informing Healthcare said provided practical evidence that the system could be used for electronic referrals.

The spokesperson added: “The Welsh Clinical Communications Gateway for e-referrals is due to be available to early adopter sites from summer 2009, followed by a phased roll out across Wales in partnership with clinical communities.

“Further development work will include use of the Gateway for electronic transfer of hospital discharge information.”

Last week, doctors in Wales called for the implementation of a secure electronic referral system as part of a series of reforms to improve the referral process in the country.

GPs, consultants and representatives from the royal colleges in Wales claim that the current referral system has been “hijacked” by the Welsh Assembly Government, and that it is aimed solely at meeting management targets to the detriment of patient care and professional relationships.

Mr Jonathan Osborne, a member of the Welsh Consultants Committee and vice-chairman of BMA’s Welsh Council, said: “It’s a situation that’s been allowed to develop because of a conflict between managerialism and professionals, which is serving only to benefit health service statistics at the moment.

"We need to redesign the process of GP referrals, with some patients being managed in a community setting, where possible.”

A series of proposals has been developed by the Welsh sub-committee of the Joint Medical Consultative Council and adopted as policy by the BMA.

The proposals say developing secure, encrypted systems for the transmission of electronic referrals would reduce management costs and delays to patients requiring urgent management, but also says any system would also have to meet the highest standards of patient confidentiality.

The paper also calls for telemedicine to be further developed to provide regular discussions between GPs and consultants.

Other proposals include re-building and strengthening the relationship between GPs and consultants, the re-introduction of consultant secretaries, agreed referral protocols and cutting down on emergency admissions by restoring the link between the GP and on call senior doctors.