E046 Clinical triage and targeting education to improve quality of referrals

Abstract Background/Aims Referral quality has been an ongoing challenge over the years. We have delivered education sessions to primary care, trialled a referral proforma and co-produced referral pathways with our clinical commissioning group. The changing workforce of primary care is important to acknowledge with more referrals now coming from nurse practitioners, pharmacists, paramedics, physician associates and first contact practitioners (FCP). This project evaluates the impact of clinical triage to help identify if we can better target education to improve the quality of referrals and the patient pathway. Methods Consultant-led triage of every rheumatology referral was introduced in July 2021. Referrals are reviewed on the electronic referral system and accepted, returned or redirected to another service. To ensure consistency standard responses have been developed. All triage outcomes are recorded in a spreadsheet alongside the referring GP practice and professional role of the referring clinician. Referral rates per 1000 patients were calculated, adjusting for population served and high and low referring practices identified. Results In January to June 2022 we received 1194 referrals; 1054 were from primary care. Table 1 shows the breakdown of referrals and triage outcome by referring clinician. Conclusion Review of triage data has helped to understand how we can target education to improve the quality of referrals. We have identified that nurse practitioners and FCPs would benefit from education focusing on what should be referred to rheumatology and what information is important to include in a referral. Many referrals were returned with a request that the patient be examined and helping clinicians understand the value of examining patients is another important theme we identified. Next steps are to organise a workshop for nurse practitioners and FCPs and to visit the high referring practices who also have higher numbers of returned referrals. Disclosure E. MacPhie: None. S.M. Fish: None. A. Madan: None. C. Rao: None. S. Horton: None.