ABSTRACT
Introduction: The COVID-19 pandemic forced many established processes to be assessed and changed, prompting new ways of working to overcome obstacles. This opened the door to a new patient referral pathway, with a nurse led screening clinic a viable option for patients as well as a development opportunity for nursing staff. Method(s): All outpatient clinics were cancelled in March 2020, with consultant slots reinstated as telephone only from April. Referrals were previously booked into a new patient consultant clinic followed by investigative blood work, before a second appointment for results. It became impractical for new referrals to be processed due to the impossibility of remote investigative blood tests, and the lack of an initial face to face review. Referrals are now screened by the attending consultant who ascertains urgency and which blood tests are required, before the patient is booked into a nurse appointment within the following month. This is a first face to face consultation where a full history is taken including medical diagnoses, family and bleed history, medications, allergies, social factors and surgical challenges. The consultation is documented electronically and blood samples are taken. The results are monitored by the nurses and repeat samples +/- further investigations are obtained, to ensure all results are available for the 1st consultant clinic appointment. Result(s): This new process enables us to safely manage urgency of appointments with clear, relevant history taking and extensive and accurate blood work being completed. This ensures all referrals into the consultant clinic are relevant and appropriate with the focus on diagnosis and discharge, as the doctor will be equipped with a full set of blood work and appropriate results. The number of patients reviewed has been steadily increasing, with 30 adults and 13 children in the past 12 months. Discussion/Conclusion: This approach enables safe screening for new patients whilst actively managing valuable consultant clinic appointment slots. It is important to be aware of the time requirement for the reviewing nurse to complete this appointment, and ensure staffing is sufficient to enable a thorough nurse led consultation to take place. Going forward we plan to formalise appointments in an official nurse screening clinic, and will also look to audit patients already seen, to ensure this approach is received as intended and to continue to obtain best practice.