1. 1 An evaluation of an eReferral Management & Triage System for MOS referrals HSD&R – 11/1022/15 Iain Pretty, Paul Coulthard, Joanna Goldthorpe, Lesley Gough, Anne Begley.

2. 2 Update To update practices on data so far Described the activity levels and case complexity within the service Describe what the DES practices may be providing Demonstrate triage system Get feedback on system and forms

3. 3 Data We have been collecting data on the submitted referrals since January They demonstrate almost 100% compliance with the online system Ortho and child only providers excluded Monthly data flows suggest around 50 – 70 minor oral surgery referrals

4. 4 Monthly Data

5. 5 Breakdown of activity

6. Care pathways 6 Securing Excellence – the new contract? Level 2 Level 1 Primary care procedures that should be delivered by and within GDS contracts Advanced level care that can be safely delivered in a primary care setting by a practitioner with additional skills and who may be on a specialist list. May be consultant supervised. Cases requiring outpatient care or care from a Consultant led team 3

7. 7 Tier Levels Tier 1 - >2 % Tier 2 – 60% Tier 3 – 37.5% Remainder sedation

8. 8 Tier Levels This suggests that over 60% of referrals could be seen in a primary care oral surgery service Given the current referral numbers this would relate to approximately 40 referrals per month This could be seen by 2 or 3 providers Activity is third molars, complex extractions, roots and apicectomies.

9. 9 Triage For the primary care services to work efficiently a triage system is required This directs referrals to appropriate providers This is undertaken by consultants in oral surgery and maxillo facial surgery Simple system, independent of providers Will not delay patient journey

10. 10

11. 11 Triage Enables rapid sending of referrals via NHS NET Enables identification of 2WW referrals Enables referrals to be automatically directed to nearest provider to patient Can utilise capacity efficiently across all providers Need to agree what to do with Level 1

12. 12 Procurement Area team will discuss the stages and timelines for procurement Will be based on a service specification informed by the health needs assessment

13. 13 Next research stages “Switch on” triage in January 2015 to feed cases to the primary care providers Ensure that quality is maintained Work on health economics Work with interviews of stakeholders

14. 14 Your feedback Jo has interviewed several practices Feedback on following phone requests What do you like? What do you dislike? What could be done better? Let us know or fill in the form

15. 15 Thank you For your attention iain.pretty@manchester.ac.uk