Implementation of a virtual cardiology clinic Betsi Cadwaladar University Health Board

The aim of the Betsi Cadwaladar University Health Board project was to support demand management and enhance speed and quality of care for new patient referrals, as part of an integrated modern outpatient service.

The team introduced a flexible 'virtual clinic' system to replace traditional outpatient clinic visits for new referrals. The virtual clinic involved nurse-led triage, office-based decisions and email and telephone contact, including anemail advice service which gave GPs direct access to a cardiologist.

Who was involved

The project was based in the cardiology service at Wrexham Maelor Hospital and focused on patients referred by GPs in Flintshire and Wrexham. The implementation group brought together nursing specialists, IT experts and administrators.

Outcomes

An independent evaluation concluded that the implementation of the virtual clinic was successful. The new referral mechanisms and processes were received positively and seen as delivering considerable benefits. GPs used the virtual clinic for diagnostic and medication issues, and for advice, reassurance and signposting.

The project delivered:

• improved access to diagnostics
• shorter waiting times for appointments and better access to urgent appointments
• more rapid resolution of patients' problems without compromising safety
• flexibility in managing patients
• concentration of difficult patients within clinics
• improved quality and efficiency
• a reduction in costs.

Challenges

The project took place at a time of significant organisational change and this created challenges around gaining staff buy-in. Engaging colleagues from primary care required the team to show how the proposal could support their practice without adding any extra work. The low number of e-advice requests limited the team's ability to test this element of the service rigorously.