A Neurology Advanced Referral Management System (NARMS) Reduces Face-to-Face Consultations By Over Sixty Percent

Area of Science:

• Neurology
• Healthcare Management
• Public Health

Background:

• The COVID-19 pandemic significantly increased neurology clinic waiting times.
• A neurology advanced referral management system (NARMS) was implemented to manage new referrals from General Practitioners (GPs).
• NARMS aimed to reduce face-to-face (FF) assessments by utilizing alternative methods like advice, investigations, or telephone consultations.

Purpose of the Study:

• To evaluate the effectiveness of the neurology advanced referral management system (NARMS).
• To assess patient satisfaction, referral outcomes, and environmental impact.
• To determine if NARMS could manage new GP referrals efficiently without increasing waiting lists.

Main Methods:

• Over six months, electronic referrals were triaged into advice, investigations, telephone, or FF categories.
• Data collected included referral numbers, patient satisfaction, inter-consultant triage variation, re-referral rates, and CO2 emissions.
• A total of 573 referrals were analyzed.

Main Results:

• 33% of referrals were directed to advice, 27% to investigations, 17% to telephone, and 33% to FF assessment.
• 95% of patients referred for MRI were content with not being seen if investigations were normal.
• Waiting list numbers did not increase, and CO2 emissions were reduced by 50%.

Conclusions:

• Two-thirds of neurological referrals did not require face-to-face assessment, with 50% managed without the neurologist meeting the patient.
• The NARMS effectively reduced carbon emissions by half.
• The system should be widely adopted, reserving face-to-face examinations for patients requiring neurological assessment for diagnosis and management.