Clinical Commissioning Forum GP Alerts Clinical Commissioning Forum 4th October 2018 Linnie Pontin Head of Patient Safety and Risk Homerton University Hospital NHS Foundation Trust

GP alerts process overview Process has been in place since May 2016 Allows GPs to raise individual patient concerns with the Homerton Standardised form and NHS.net email address in place Alert is acknowledged within 3 working days, and we aim to provide a response back to the GP within 25 working days. Alert reviewed by member of the Quality and Patient Safety Team, then circulated to division for action / investigation. Response reviewed by Quality and Patient Safety Team to ensure response answers query before it is submitted. New to process in 2018 All GP alerts are reviewed weekly at the divisional Complaints, Litigation, Incidents and PALS (CLIP) meetings, which are chaired by a member of the Divisional Management team. More senior oversight of process and alerts. Closer links with the Business Development Team

2017/18 Number Total 2017/18 Alerts received 69 Average number of days to acknowledge receipt (range) 3.04 (1-10) Total closed within 25 days 33 Average days to closure (range) 41.5 (1-173) Alerts received from 32 different practices. Top reporting practices: Cranwich Road (11) Heron Practice (7) Nightingale Practice (5) Cranfield Surgery, Cedar Practice, Lawrence House, Lawson Practice (3) All others either one or two alerts a year.

Total April – September 2018 2018 to date… Number Total April – September 2018 Alerts received 28 Average number of days to acknowledge receipt 1.85 (1-4) Total closed within 25 days 21 11 Average days to closure (range) 30.6 (7 – 98) Alerts received from 12 different practices. Top reporting practices: Heron Practice (11) Stamford Hill, Hoxton (3) Well St , Cranwich (2) Athena, Gadhvi, Lower Clapton, Nightingale, Spring Hill, Trowbridge (1) Still some work to be done around response times, but there is now more senior oversight and scrutiny of both the process and the quality of the responses being submitted.

Key themes / outcomes Three main themes from GP alerts: Results – mainly related to delayed, missing or multiple results Referrals- missing or delayed referrals from a variety of departments Documentation – mainly missing communication between hospital and GP. Sick note – failure of HUH to issue. Better oversight and closer working between the patient safety / complaints / legal services / patient experience teams means the themes raised in these alerts will now link into overall quality picture – link into risk registers etc. Issues not confined to GPs – results management is an issue internally as well.  

Serious Incidents / HUH follow up GP alerts process has value for HUH as well as for GPs. SI declared relating to a patient who underwent a fine needle aspiration of thyroid. The team were unaware the patient had suffered infected haematoma which required emergency transfer to Royal London Hospital with suspected compromise of airway. Issues relating to toxicology tests (particularly relating to antenatal patients) have been identified and are currently being investigated with the lab.

HUH clinician feedback process April 2018 – new process of HUH clinician feedback introduced. SOP and form developed with CCG and approved for use. Available on intranet but not widely publicised to date so system not up and running yet. Programme of awareness raising throughout Autumn Watch this space!

Any questions?