P365 Gastroenterology outpatient transformation – clinical assessment service (CAS)

IntroductionIncreasing referrals lead to prolonged waiting time for patients to be seen in the clinic, creating pressure to comply with national guidance on referral to treatment time and raised appointment slot issue.MethodClinical assessment service clinic was introduced to assess and manage patients remotely without face to face appointments.Currently we are running 2 Virtual Gastroenterology clinics per week, where 40 patients are reviewed.New referral in CAS clinic results in the following 5 outcomes; inappropriate referral, face to face appointment, appointment with/after results, review remotely after investigations, advice to GP and discharge.Results1254 patients have been reviewed in CAS clinic in 9 months. 21.1% of those patients were discharged with advice to GP on first assessment of the referral, including inappropriate referrals. Out of remaining 937 patients, 64.7% went directly for investigations and 113 patients were discharged after investigations, following a remote review.ConclusionCAS clinic faced challenges initially, such as familiarizing GPs and staff to the system. This was dealt with, by reaching out to them, conducting awareness seminars and teaching sessions run by the Consultants. CCG and administration were supportive.DNA (did not attend) rate fell to 0% and the process helped save new and follow up appointment slots. The Trust gained a financial benefit of £117,259 in 9 months. 86.7% of patients were satisfied with the process. The department is planning to increase the number of CAS clinics in future.