Blogs

How we’ve worked with GPs to cut waiting lists and get patients quicker care in gastroenterology

With our Advice and Guidance service we set out to deliver the best possible care with the minimum delay. We picked a small team of consultants with the right skills and experience to deliver “remote expertise” well and we have worked together with our GP colleagues to develop a service that is now the best in England with respect to 18 week performance and allows us to see patients in clinic within a month.

British GPs are among the best in the world, nowhere more so than in Northumbria, with a proud tradition of looking after the “whole patient” near to where they live. Secondary care is evolving. In 2025, we believe the best way a specialist can serve their patients and GPs is not the same as it was in the last century. With electronic access to both GP and hospital records, and taking advantage of modern near-patient testing, we can now make safe, accurate and rapid judgements, tailoring the best response for the patient and their GP. Sometimes this will involve a conventional outpatient appointment, and we can typically do this within 2-4 weeks; sometimes we can arrange directly for diagnostic tests without needing an appointment first. In many cases however we can thoroughly review the case and offer expert specialist advice that empowers the GP and patient to manage the problem without needing to wait to see us.

Adopting a mantra of “discuss with, not refer to” we have embedded a new culture of co-operation across the primary/secondary care interface. Our GPs tell us they value our personalised approach and our support for holistic care in the community. As a result, we have reduced waiting times, reduced the number of low diagnostic value endoscopic procedures in the very young and high-risk interventions in the very old, thus making best use of precious resources and minimising harm.

We believe a quality Advice & Guidance service is one component of a wider approach to quality improvement and we have strong evidence that our success can be replicated in other medical and surgical specialties and across the wider NHS.

Dr Richard Thomson & Dr Matt Warren | Consultant Gastroenterologists at Northumbria Healthcare