In this episode Charlotte takes you through the referral process from both a GP and PML perspective.

You’ll hear from GP Dr Tim Breese who explains what he does when one of his patients needs a scan.

And you’ll hear from PML’s Jon Pither about what happens once a referral is received - sharing the admin and triaging processes to make sure everything goes smoothly and effectively for your appointment. 

If you have any extra questions about your appointment or referral to PML you can get in touch with the team via the Physiological Measurements website physiologicalmeasurements.com

Episode 2 What Happens After Your GP Refers You to PML? Transcription

Welcome to the Physiological Measurements podcast for patients who've been referred for an appointment for a scan. I'm Charlotte Foster and I've been taking a look behind the scenes at head office in Shropshire, as well as speaking to one of the sonographers who works in one of the clinics. Throughout this series, I'll be finding out just who PML are, the work they do and what you can expect as a patient. If you're listening to this, you have more than likely been referred by your GP for a scan of some type, and you've been told it's PML who'll be doing it, and you might well be wondering why this has happened and what it means for you. Are you still being treated by the NHS, or is this now a private appointment? Are you going to be treated any differently?

Will you notice anything different? To answer some of those questions, I'm joined now by doctor Tim Breese.

He is a GP in Shropshire and he refers some of his patients to PML for appointments.

The typical patient would be possibly a patient with heart failure, who, I would see, that needs further investigation, and an echocardiogram would be indicated and the referral would then be made. That option can be either directly to a cardiologist, depending on how severe and acute the problem is, or you can go down the own investigation yourself and decide to investigate it at a general practice level. So referral for blood tests and an echocardiogram would be one of the first appropriate steps. The physical process is quite simple from my point of view. On the computer, there are various forms that are mostly self-populating that fill in the reasons for referral, and in this case, it would be heart failure, breathlessness and you tick the box echocardiogram, and the secretary would send it off. Now, these particular referrals end up with PML, and the appointment is then sent out from PML to the patient.

So from a patient point of view, you're not really doing anything different than if they were going to go straight to a hospital or it was going to be kept within the NHS completely.

No, it's not. No different from me ordering a blood test or any kind of other radiological investigation. It's very straightforward, really. It's just where the referral ends up and who the provider is. In which case, obviously, it's PML.

At this stage. Do you tell the patient that it might be an external supplier, for want of a better word?

I tell them it is to an organisation that is based locally, so that they don't have to travel 20 miles, 30 miles to the nearest hospital to have this investigation done. It's, in fact, it's only five minutes away. Now, most of these referrals tend to be elderly patients, either lacking in transport or would find driving 20 miles quite challenging. So the thought of having just to go locally to somewhere they know, most of them would find this very welcome, rather than having to travel so far, really. So it's well accepted from their point of view.

Is there anything else from this side of things that you think is important for people to know about? They've had that leaflet through, or the letter through the door saying they're having their tests done by PML. What else from your side of things, when you're making that referral, do you think is important for patients to know?

Normally, they'll get offered an appointment very quickly, probably more quickly than if they went off to the local district general hospital. Tell them the results normally, come back very quickly and we'll review the results with you once the procedure has been done.

Thank you so much to Dr Breese

For chatting to me and sharing just what goes on from his side of things when it comes to referring patients to PML. Now, to understand what the process looks like from the PML side of things, I'm joined now by Jon Pither, who is one of the directors and co-founders of PML.

When a GP sends a referral over to you guys, what's the first thing that happens?

Referrals come to us normally via a service called e-referral. So this is sent direct from the GP surgery through the NHS system. Or we might get an NHS email into our NHS email, which again, is secure. The referral will be effectively a PDF with, hopefully, the correct patient details. So, name, age, NHS number, the type of test that the GP has requested, along with a summary of what is wrong with the patient. So that might be pain, left upper quadrant, and there'll be for an abdominal scan. So we do a number of checks. So the first thing we do is what we call admin triage. That's to make sure that we've got all the information that we need in order to contact the patient.

If that's correct, then it then gets added to our clinical triage. If it's incorrect, it gets sent back to the GP and then clinical triage. So that's undertaken by one of our senior sonographers and that's to make sure that the GP has ticked the appropriate test based on the clinical information that's given. So if we have pain in left upper quadrant of the abdomen and they've ticked ultrasound shoulder. That's wrong. So the sonographer would then reject that referral. That goes back to the GP. The GP then would check and put the right type of test.

So you wouldn't just go, well, I know what that needs, and tick. The GP has to do it properly.

Once the referral has been clinically triaged, it's then added to our waiting list and that's when the staff in the patient management centre will then virtually take off those details. We will then send SMS or text message out to patients asking them to either contact us or letting them know that we will contact them. And the phone number that we'll be calling them from so they can expect our call. So if people get a, you know, a number that they don't know, often they won't answer the phone. Obviously some patients don't have a mobile phone, so we will hopefully have a landline we can call them. Last resort is we would just send them a letter.

And then once people have heard from you, what's the reaction generally? Are they happy to hear from you or is there sometimes some worry?

I think most of the time people are quite pleased that they've been contacted quite quickly since they've had their appointment with their GP. So most of the time we'll do the admin and clinical triage within 24 hours. So we're contacting patients quite quickly. They're then seen, you know, if they're urgent scans, it might be next day or two days.

Quite quickly.

Yeah. Or if it's routine, generally it's between one and three, maybe four weeks, we'll see the patient and again, the time taken to get their appointment might also depend on where they want to be seen. So there might be a clinic that's a little bit further away, but they can be seen sooner, or if they want to be seen literally down the road, they might have to wait a bit longer.

So people have options, ADD JP HERE patient choice 8'16 And does that choice also include not being seen by you guys or requesting to go to somebody else or requesting go for just complete NHS?

Yeah. I mean, patients have a right as to where they want to be seen, so if they want to be seen at their local hospital, they can do that. But often the reason that we're delivering a service is because the local NHS Trust or hospital will have significant waiting lists..

And then they're booked in. And that's the referral bit over and done with, isn't it?

Pretty much, yeah. So once the patient has had their text message they'll either ring in or somebody will ring them from the patient management centre and have a conversation over the phone and arrange which clinic they want to be seen in. And then that information is all put in a letter and sent out to the patient with information about the tests that they're going to have if they need to do any prep, what to expect, that kind of thing.

I think it just really goes to show the work, as we sort of said in episode one, the work that goes into getting the appointments in place and start with it. So thank you for sharing that with us.

Thank you.

Thank you to my guests today for spending time with me and sharing such wonderful knowledge. And thank you for listening to this episode of the Physiological Measurements podcast. I hope you enjoyed it and found it useful. You can find out more and get in touch with the team by visiting the website physiologicalmeasurements.com