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Self-referrals should increase by at least 15,000 per month, ICBs told

Self-referrals should increase by at least 15,000 per month, ICBs told
By Beth Gault
10 April 2024

The number of patients self-referring to services should increase by at least 15,000 per month by March 2025, NHS England has told ICBs.

The self-referral requirement was part of NHS England’s primary care recovery plan, published in May 2023, which aimed to ‘empower patients’ and free up GP time in order to improve access. It covered seven pathways: falls response services, musculoskeletal services, audiology, weight management services, community podiatry, and wheelchair and community equipment services.

In an update letter to ICBs, published yesterday, NHS England said that there were 41,000 monthly self-referrals in November 2023, and that they were on track to meet the goal of 45,000 by the end of March 2024. However, that an additional 15,000 should be self-referring per month across all pathways by March 2025.

It said: ‘By March 2024, we are on track to increase by 50% the number of people self-referring to the seven community services prioritised where general practice involvement may not be necessary – an additional 15,000 patients a month.

‘However, there remains variation across integrated care boards (ICBs), pathways and providers; and therefore opportunity exists for more people to benefit from self-referral in these services, as well as others where self-referral may be clinically appropriate.

‘Our goal for 2024/25 is to further increase self-referrals across all pathways by at least a further 15,000 patients a month by the end of March 2025, by working with ICBs to reduce variation and ensuring healthcare staff and patients can readily understand availability of self-referral locally.’

In January, it was revealed that only three ICBs had met NHS England’s recovery target to expand self-referral pathways by the end of September.

Primary-secondary care interface

The letter also provided an update on the primary-secondary care interface, after the recovery plan tasked ICB chief medical officers (CMOs) to report on progress on improving this.

It said that ‘good progress’ had been made in some areas, but that ‘there remains more to do in all systems’ and that NHS England would be providing more support on this.

It said: ‘Our goal for 2024/25 is provide more support to ICB CMOs with national leadership co-led by the NHS England national medical directors for primary and secondary care.

‘We have already asked ICBs to report progress through their public board in April or May and will again ask ICBs to do this in October or November 2024. This will be a focus for 2024/25 and we are looking for significant progress on implementation, recognising the benefits for patients and staff alike.

‘In 2023/24 we developed an assessment tool at the request of many ICBs. In 2024/25 we are asking all ICBs to use this across their secondary care NHS providers, to baseline, improve and report on progress as they implement the Academy of Medical Royal Colleges recommendations and RCGP interface guidance. Themes from the assessment tool will inform future support and guidance including content for October or November board reports.’

Other progress expected from ICBs during 2024/25 included:

  • To grow monthly patient volumes at pharmacy services by:
    • 320,000 Pharmacy First clinical pathways consultations;
    • At least 71,000 blood pressure check consultations;
    • 25,800 oral contraception consultations.
  • Roll out ‘easy-to-use online registration’ service to 90% of GP practices by 31 December 2024.
  • Resolve ‘any outstanding issues’ for the practices who do not yet offer prospective record access.
  • Primary care networks (PCNs) should review how digital telephony is being used across practices (including number of calls, average wait, abandonment time, average call length) to support ‘quality improvement’ in how demand is managed. NHS 111 call data will be shared with PCN clinical directors to ensure they only divert to them in ‘exceptional circumstances’.
  • Increase the use of ‘higher quality’ digital tools used by GP practices. It said ICBs would be funded to support practices to secure these.
  • Support practices to implement a ‘single view’ of all patient requests, whether online, phone or walk-in.

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