E-referral almost complete in Wales

NHS Wales is approaching the completion of the roll-out of its e-referral system, with more than 90% of GP practices now using it.

The Welsh Clinical Communications Gateway was first implemented 18 months ago and allows clinical messages to be sent securely in an electronic format from the GP to the hospital, replacing patient referral letters.

Dr Martin Murphy, clinical director at NHS Wales Informatics service, told EHI Primary Care that the idea stemmed from work by NHS Scotland, which has implemented the Scottish Care Information Gateway, which is used by over 95% of GPs.

“We looked at what Scotland had done in helping their GPs with referrals and they were willing to share that with us. We rebuilt that service to suit us and we have found that it significantly improves the referral behaviour between GPs and hospitals.

“The system is fully auditable and we don’t lose referrals in the post which has provided a significant safety improvement. It has also provided benefits in the form of speed and efficiency savings,” he explained.

The gateway, which is used by all health boards in Wales, has been developed by NWIS in conjunction with the Scottish Executive’s eHealth programme, the Scottish Care Information team, local GPs, the Vale of Glamorgan Local Health Board’s Referral Management Centre, Cardiff and Vale and Abertawe Bro Morgannwg University health boards.

The system processes around 650,000 referrals a year using a set of templates that automatically populate parts of the form, with data extracted from the GP’s local system. 

This minimises the keying-in of information and ensures that hospitals receive a standard set of information about each patient.

Murphy described the system as a “postbox” and said that in North Wales coverage is at 100% with paper referrals down to less than 100 a year. He expects near 100% coverage across Wales in the next three months.

He also told EHI that health boards are in the process of exploring how the gateway can be used for discharges, with 45 GP pilots underway. The system can also manage messages from “any to any” healthcare setting, including from organisation to organisation.

Murphy said: “ ‘any to any’ work will be decided by the respective health boards in their business plans. In another three months there will be 100% coverage of the system in Wales and our aim is to standardise all of our systems and business solutions.”

Other future benefits include the integration with hospital patient administration systems to allow electronic workflow to the consultant and the prioritisation of referral letters.