Innovation in Healthcare Award: change from the front lineBMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g2487 (Published 08 April 2014) Cite this as: BMJ 2014;348:g2487
- Zosia Kmietowicz, associate editor
- 1BMJ, London, UK
It is often said that frontline NHS staff know exactly how to improve care for their patients; they see the answer every day. The BMJ Innovation in Healthcare Award celebrates how that knowledge is shared with colleagues and acted on to deliver change. It takes commitment and collaboration to succeed but also courage to raise the possibility that things could be done differently.
Improving general practice referral, Tower Hamlets CCG, London
General practice referrals in Tower Hamlets, east London, had been creeping up for several years, when in 2011 general practitioners decided that action was needed. But Victoria Tzortziou Brown, a local GP and clinical commissioning group lead on planned care and research, said that doctors wanted to avoid a referral management centre because they “introduce another layer of administration, add costs, and deskill and undermine GPs.” Instead the CCG developed a package of interventions to improve the management of common conditions in four specialties—musculoskeletal disorders, dermatology, urology, and ear, nose, and throat—and targeted referral behaviour. The interventions were rolled out across all 36 general practices in Tower Hamlets with a “referral champion” in each of eight general practice networks.
Auditing and discussing 2670 referrals at practice meetings over the following months led to a 15% fall in referrals and a rise from 68% to 79% in recording of suspected diagnosis and history in referral letters. Variation between practices also levelled out, with the biggest reduction seen in dermatology …