Gloucestershire NHS pioneers new way of getting care to patients

NHS hospitals and GP surgeries across Gloucestershire are pioneering a new way of getting care to patients. They’re embracing an innovative system built by an NHS surgeon which 'beams in' consultants to GP appointments and paramedic visits to offer advice in real time; reducing unnecessary hospital admissions whilst ensuring urgent cases are prioritised.

The smart referral platform, called Cinapsis, connects primary care clinicians (such as GPs, paramedics and community nurses) with consultants from the local NHS Trust. This allows consultants to assess patients via voice calls, image sharing, or messaging. Patients can then be appropriately referred; whether that’s to A&E, a specialist appointment, or community based care. This minimises the number of unnecessary referrals and takes pressure off waiting lists.

Cinapsis is being used across the One Gloucestershire Integrated Care System (ICS) - which includes Gloucestershire Hospitals NHS Foundation Trust, Gloucester Health and Care Trust, the South Western Ambulance Service Trust and all of the region’s 73 GP practices.

Prior to COVID-19, the platform was already in use and had enabled large numbers of referrals in the region - such as 70% of dermatology referrals - to be successfully managed without a face-to-face appointment with a specialist. Instead, expert advice is accessed in real time via GPs, nurses and paramedics. Likewise, unnecessary A&E referrals in the region have reduced by 83% thanks to the technology.

During the crisis, the platform has enabled some 32% of patients ill with suspected COVID-19 in Gloucestershire - who GPs or paramedics were concerned about - to avoid hospital and instead be successfully cared for at home, relieving pressure on hospitals at a critical time.

The platform is now set to help the NHS and communities triage patients more effectively and give patients immediate access to specialists via primary care settings. This will ensure all patients can access the best advice quickly, whilst requiring fewer patients to join growing waiting lists for in-person hospital appointments.

Founder of Cinapsis and NHS surgeon, Dr Owain Rhys Hughes, says: “At this critical time, Cinapsis is making it easier for GPs and emergency healthcare workers to quickly identify the best course of action for any patient, in collaboration with specialists. Whether that’s sending them to hospital or advising on care in the community, specialists can respond to messages in seconds to ensure decisions are made quickly and seamlessly.

“This is crucial at a time when we run the risk of serious collateral damage in public health post-COVID. The NHS is facing a huge build up of demand due to coronavirus treatment delays, so we’re ensuring patients can still access specialist advice without adding to this pressure. We empower GPs, nurses and paramedics to identify patients who are better placed to receive care in the community and ensure those who do need hospital-based care can access it as soon as possible.

“Our mission is to ensure all patients can safely access the specialists they need when they need them, whilst supporting hospitals by facilitating more care in the community. This is already proving crucial in Gloucestershire, as clinicians work tirelessly to support patients following several months of disruption to normal practice.”

Dr Malcolm Gerald, lead GP on the Cinapsis project in Gloucestershire, says:

“Not only are we helping to reassure and better manage our patients by giving them the benefit of specialist advice, we are also reducing demand on busy hospitals by making properly informed decisions. Our data shows that following discussion with a specialist around a third of COVID-19 patients whose referring clinician had significant concerns about them did not need to be admitted to hospital. This has reduced unnecessary patient, family and staff exposure to the virus, whilst keeping important bed space free for those most in need.”