Rapid specialist opinion (RSO) Rapid specialist opinion (RSO)

'Right Place, First Time’

These questions and answers have been written to help answer any queries you may have about the local referral process called Rapid Specialist Opinion (RSO).

1. What is changing?  

It is recognised that in Hambleton, Richmondshire & Whitby, we are in financial deficit because of an overuse of hospital based services.  We all have an important role to play in correcting this, without damaging the quality of patient care.

The CCG and its member practices, has a statutory duty to make the best use of resources and not exceed our financial allocation. This is about spending money where it is intended and in the best interests of the whole population. 

2. What is Rapid Specialist Opinion (RSO)?

RSO is a new process being introduced in the Hambleton, Richmondshire and Whitby (HRW) area with effect from Monday 3 September 2018.  The process oversees the management of referrals ensuring that patients are seen in the right place, first time.

When you go to see your GP, you might need to be referred to a local hospital (known as secondary care) or a specialist for the next stage of your treatment.

At the moment, a lot of people in Hambleton, Richmondshire and Whitby are being referred for outpatient appointments when they could have received treatment closer to home.  This puts extra pressure on our local hospitals (such as James Cook University Hospital, Middlesbrough and Friarage Hospital Northallerton), diverts resources away from those patients with the greatest need, and is costly to the NHS at a time when every resource in the health service is precious. 

3. How will it work?

When a patient goes to see their GP, sometimes it is necessary for them to see a specialist or go to hospital for the next stage of their treatment.  To initiate this process, a GP will make a referral. 

With RSO, the referral will be reviewed by a Consultant or a GP with a Special Interest in the patient’s condition (e.g. dermatology) to make sure that the patient goes to the right place, first time.

The RSO Consultant or GP with Special Interest will use their specialist expertise to take a view on the best course of action for you, based on the information provided in the referral by your GP.  This could be a recommendation for you to be treated in secondary care, or for your needs to be met in a primary care or community setting.

4. Why is the process being introduced?

We know that not everyone who currently has to go to a hospital out-patient appointment really needs to. We also know that it can be stressful and inconvenient for patients if there are alternatives ways to be treated and or receive treatment.

5. So is this about cost cutting?

Absolutely not.  This is about ensuring that our valuable NHS resources are used effectively, and that only those people who really need a hospital appointment, get one.

By introducing the scheme, it means that those patients who do need to be referred to hospital or to see a specialist will not have to wait as long.

For those who don’t need to go to hospital, they will receive their treatment closer to home and will be supported by specialist advice from RSO clinicians and their GP.

The process will also allow NHS clinicians to focus their time on patients with the greatest need.

6. Who will deliver the service?

The CCG has commissioned ‘About Health’ an experienced provider of community based health services to the NHS.  About Health employ experienced Consultants and GPs with a Specialist Interest who will use their expertise to undertake a clinical review of referrals.

7. Which referrals will be included in the RSO process?

The process will include:

  • Ear, nose and throat services (ENT)
  • Dermatology – skin services
  • Gastroenterology -digestive system
  • Gynaecology – women’s health
  • Ophthalmology – eye services
  • General Surgery - operations
  • Urology – “waterworks”
  • Plastic Surgery – skin services
  • Cardiology – heart and circulatory conditions

8. How does this scheme affect cancer referrals?

Two week wait referrals for suspected cancer are not part of the RSO process.  In these cases GPs will use their normal referral process.

9. When will this new process start?

The process will go live on 3 September 2018.

10. What happens once my referral has been reviewed?

If a patient DOES need to see a specialist or have a hospital appointment, they will be sent a hospital appointment at the location of their choice.

If a patient DOES NOT need to see a specialist or have a hospital appointment, the RSO specialists will contact their GP practice to agree a plan on how to manage their healthcare locally, without the need to go to hospital for treatment. Your GP practice will contact you to get the specialist advice put into action.

11. Can patients still choose which hospital to go to, if this is necessary?

Yes you still have choice. Occasionally the service you require will not be available at your preferred place, in which case we hope you will be satisfied with the alternative arrangements.

12. What if I receive an appointment date and time that is not convenient for me?

Upon receipt of your appointment confirmation, you can re-arrange the date and time by using the telephone number provided or do so online.

13. How will this affect waiting times?Surely by adding another layer in the process it will slow things down?

For some areas of care there are currently long waiting times.  If we can reduce the number of people who visit hospital unnecessarily this new process can help reduce waiting times.

14. How quickly will referrals be triaged by RSO?

The specialist team will provide clinical triage within 2 working days of the referral being sent, and then the outcome will be processed within 1 further working day. (This will sometimes be faster as the individual triaging clinicians may process referrals on a daily basis). We don’t envisage this causing a delay in treatment.

15. What will happen if my GP disagrees with the specialist opinion?

The GP can raise any concerns with the RSO consultants and the CCG.

17. How will the process be reviewed to ensure it is effective?

As commissioners, we monitor and evaluate the services we plan and purchase on a regular basis. 

18. Who will see my referral information?

RSO will be part of the NHS System within Hambleton, Richmondshire and Whitby.  About Health, who will manage the review of referrals are a commissioned provider of NHS services.  Information shared will only relate to your condition and anyone who needs to see the information is bound by the confidentiality rules of the NHS.

19. What if I still have questions about RSO that my GP Practice is unable to answer?

You can contact the CCG patient relations team:

By email:  HRWCCG.PatientRelations@nhs.net
By phone: 01609 767607