A comparison between Kinesis A&G and eReferral System Advice & Guidance

Advice and guidance for the NHS

Comparing NHS Advice and Guidance Systems

The Advice and Guidance capability in eRS (Choose and Book) appears to provide some similar functionality to Kinesis Advice and Guidance, however we recommend that the following points are considered when reviewing both systems.

Kinesis benefits:

Cost Effective

Kinesis A&G rapidly pays for itself in cost savings from avoided referral fees. Avoiding just ¼ of unnecessary referrals would save NHS England >£500M per year.

Clinically Effective

Ensures faster access to appropriate care for patients, improving their clinical outcomes. Appropriate care starts tomorrow or the day after, avoiding weeks of wait time for outpatient appointments. Patients are reassured, GPs treat with increased confidence.

End-to-end process 

Six years of active development in a real-world setting, to ensure the entire advice and guidance process is seamless, very low effort, efficient and assured.

Better use of NHS resources 

Reduces unnecessary load on critical NHS services, especially outpatient clinics and limited consultant sessions. Positive impacts on A&E.

Rapid adoption 

Get started in 1 to 2 weeks with our help, full documentation and active training and support to accelerate adoption across the settings. Clinicians rapidly habituate practice and organisations it their improvement and CQUIN targets.

Outstanding user experience

GPs and consultants rate Kinesis A&G at 4 or 5 stars for ease-of-use: designed for clinical work patterns, fast and easy-to-use, dynamic user alerting and escalation, plus the new ability to access remotely via mobile devices all lead to better adoption and earlier benefits.

Advanced features

Intelligent features for out of office, working hours, delegation, starters and leavers, group working and so much more places Kinesis A&G at the very forefront of next-generation NHS systems, designed for users and organisations.

Enables communication and education

GPs rapidly learn from advice and improve their referral and clinical practice. Consultants actively pass expertise to primary care creating systematic improvement.

Built-in reporting and management

Advanced reporting to drive up adoption, identify poor responders, enable billing and track usage. Kinesis A&G is the only advice and guidance system with full management capabilities for organisations who take referral avoidance seriously.

Referral avoidance – NHS Advice and guidance

  • Kinesis use is fully controlled by CCGs so the consultants and specialists that GPs want can be contracted onto the system. It builds meaningful relationships with local consultants and providers.
  • The design of the system, escalation technology and nature of the relationship between primary and secondary care assures users that requests will be answered in a timely fashion (>60% within 24 hours). Over 80% of all requests for advice are answered within 72 hours.
  • A payment mechanism for advice that leads to an avoided referral (based on the non-face-to-face tariff) is made to the secondary care trusts encourage quicker and more enthusiastic engagement. GPs are always confident that they will get an answer in a predictably quick timeframe.
  • Automatic notifications and escalations are built into the system.
  • Allows a full discussion (unlimited replies) until the clinical professionals have sufficient information to proceed, with tracking and archiving.
  • Activity is logged and tracked and this transparency enables CCGs and providers to manage the system and act on any issues.
  • Kinesis provides outcomes data, accessible through the administrator dashboard with a powerful range of standard reports. Data may be exported for further analysis and ad-hoc reports to be easily created.
  • Consultants /specialists have the option of working as a group or as individuals and can redirect to a colleague if they think the colleague would be more appropriate.
  • Designed to be very simple to learn and use and is optimised for speed of use for busy clinicians. It is common for a GP to be able to complete a Kinesis conferral in the time it takes to login to Advice and Guidance
  • Built expressly for this type of communication; quantitative evidence shows that it is working, obtains engagement from both GPs and consultants, is auditable and demonstrably saves money and improves patient care.
  • In questionnaires, GPs and consultants consistently rate ease of use at 4 or 5 on a scale of 1 – 5.
  • Has a full, user-request led development model included in the pricing structure, that ensures the roadmap aligns with user needs. Monthly or weekly release cycles and hot-fixes with documented Release and UAT process. Users have the right to participate in active user group and steering group to provide feature requests, design input and prioritisation.
  • Includes an extended range of real-world functionality designed to deal with complex and edge case scenarios including:
    • GPSIs, Out of Office, Working days
    • Delegation
    • Referral flipping, redirect, instant messages
    • Toast, wall and system messaging
    • Specialist groups, consultant initiated messages
    • Practice level management
  • Actively involved and supportive Kinesis team
  • Although eRS Advice and Guidance is provided to NHS organisations at no cost, Kinesis users see a greater cost saving and better clinical outcomes due to much higher uptake and reliable and assured responses to advice requests (known as conferrals). Savings per CCG are seen to be sustainably in excess of £500,000 per annum
  • Liked by users

Challenges for eRS Advice and Guidance?

  • There was a lot of dissatisfaction with Choose and Book at all levels i.e. patients, GPs and providers. Many GPs found it clunky and time-consuming to use. In its current release eRS reproduces the functionality of CAB, so similar concerns from users may be found. Advice and Guidance functionality is secondary to booking and as such is not as developed and is not the main focus for users.
  • Penetration and usage of Advice and Guidance remains low.
  • Development continues to be centrally directed rather than driven by direct user engagement
  • There is no guarantee that a GP will find his preferred local clinician and it doesn’t lend itself to the building up of relationships with local providers.
  • There is no management framework for integrating Advice and Guidance into the primary-secondary process; no service level agreements are put in place meaning that there is no commitment by specialists to respond within a useful timeframe. Advice and Guidance lacks notifications or reminders to drive responses. There is not the same level of predictability in terms of responses for the GP.
  • GPs/requestors need to know the consultant or be aware of their support arrangements to be able to initiate contact.
Simon Hudson

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