1. Croydon Health Services Paperlite GP Referrals – Using the Service Provider Functionality within ICE Croydon Healthcare NHS Trust is using the Service Provider List functionality to introduce paperlite electronic referrals from primary care. This presentation is a review of the proposed plan, current progress and lessons learned from the implementation. Omar Ali Croydon Health Services

2. Seen as a first step towards a Paperless referral workflow Removal of paper request and faxing referral Positive Patient Identification Integration with GP Clinical System Clinical Information captured in ICE Streamlined Referral Process Audit available ICE Referral Advantages

3. ICE Referral Timeline for Primary Care Pathology Supplies Referrals Cancer Service Referrals 5 Licence limit purchased in 2014 Cardiology Service Referrals Radiology Ordering of Exams not routinely available to Primary Care Unlimited Licences purchased in 2015 to proceed with development of other referrals (e.g. pregnancy, audiology, endoscopy)

4. Cancer Referrals ICE referral build based on national guidelines for Cancer Initially requested to design by Cancer Services in 2013 Delay in purchasing ICE Service Provider licenses Clinical validation by Trust Clinical validation by Primary Care Pilots commenced 1 st July 2015 for three practices Currently awaiting CCG/GP IT Group approval to proceed to full rollout

5. Cancer Susp Brain CNS Cancer - Referral Form

6. Cancer Susp Brain CNS Cancer - Previous Pathology Results

7. Cancer Susp Brain CNS Cancer - Clinical History Details

8. Cancer Susp Brain CNS Cancer - Generic Questions

9. Cancer Susp Brain CNS Cancer - Patient Awareness Questions

12. Cancer Referral - Service Provider List

13. Cancer Referrals made on ICE ReferralJul-15Aug-15Sep-15Oct-15Nov-15 Grand Total Suspected Brain and CNS Cancers Referral1 0 0001 Suspected Breast Cancers Referral25112020 Suspected Colorectal Cancers Referral1557119 Suspected Gynaecological Cancer Referral37713030 Suspected Haematological Cancer Referral120104 Suspected Head and Neck Cancers Referral2468121 Suspected Lung Cancers Referral4322011 Suspected Skin Cancers Referral710811238 Suspected Upper GI Cancers Referral11967033 Suspected Urological Cancers Referral5728022 Symptomatic Breast Referral0 22419 Grand Total375439735208 November 2015 data only to the 3 rd November Pilot LocationJul-15Aug-15Sep-15Oct-15Nov-15 Grand Total EVERSLEY MP (H83020)14281128485 GREENSIDE MED PRAC (H83631)13171517062 QUEENHILL MP (H83014)1091328161 Grand Total375439735208

14. Issues raised by Pilot Sites Entering Clinical History in the referral Amended build to add clinical details as a free text field. Set field limit at maximum 2048 characters to support cut and paste from practice system Identification of Pathology Results Changed prompt to indicate that results were available to be viewed on ICE rather than manually transposing data No notification that referral received and appointment given to patient An operational issue. Suggested the use of ICEMail, Patient Notes and Write Report within ICE Not all Cancer Referrals are done via the Croydon Team Referrals created directing the requestor to the correct referral process to be used Operational process within Trust of passing on the referral to the clinicians Currently printing out referral and scanning to a document management system

15. Methods of Entering Pathology Results to a Referral Prompt to indicate result available on ICE Enter as a numeric result View previous result if present within ICE

16. Using ICEMail to Inform GPs of first Patient Appointment

17. Informing GPs of Patient Information Using Notepad

18. Sunquest ICE Service Provider Access For GPs launch IE or similar and enter the URL https://iceweb-1.croydonhealth.nhs.uk/icedesktop Save this to favorites Enter generic username iPractice Code e.g. iH83123 & Password e.g. h83123. Click icon Location Request List https://iceweb-1.croydonhealth.nhs.uk/icedesktop iH83123 h83123 Apply filters accordingly by 1.Requesting Doctor: 2.Provider: 3.Days: 4.Start Date: 5.End date: A patient list is displayed. Under status column click RR Report Received to view a mini report. Click Goto Full Report

20. Click download to file a copy into patient record and Back to return to patient list. 7 Click on a patient row to open menu options 8 Important Contacts Andrew Widdowson AST Application Manager 3468 CUH Support Desk: 020 8301 3000 Ext 3838 Prepared by Omar Ali Version: 1.0 Date:20/10/2015 Click View Order for the referral with additional Information or View Audit Trail for history of actions and by whom 9 Referral with Additional Information 10 Audit Trail of Actions 11

21. Cancer Referrals – Referrals to Non Croydon Site