[ { "page": 1, "items": [ { "page": 1, "type": "TITLE", "location": { "l": 98.3703, "t": 813.6951, "r": 453.9428, "b": 770.2628 }, "text": "Reducing the Admin burden of referrals: A practical guide for Primary Care", "reading_order": 0, "level": 1 }, { "page": 1, "type": "FIGURE", "location": { "l": 51.3445, "t": 757.5451, "r": 93.3318, "b": 719.8718 }, "text": "", "reading_order": 1 }, { "page": 1, "type": "FIGURE", "location": { "l": 309.5064, "t": 758.9848, "r": 357.4919, "b": 708.3538 }, "text": "", "reading_order": 2 }, { "page": 1, "type": "TITLE", "location": { "l": 358.4517, "t": 747.7068, "r": 521.8423, "b": 713.6329 }, "text": "Feedback from secondary care clinicians", "reading_order": 3, "level": 2 }, { "page": 1, "type": "TITLE", "location": { "l": 94.7714, "t": 745.5472, "r": 145.3961, "b": 731.1498 }, "text": "Context", "reading_order": 4, "level": 3 }, { "page": 1, "type": "TEXT", "location": { "l": 35.9891, "t": 718.1921, "r": 263.4404, "b": 636.8466 }, "text": "As we move towards Advice and Refer\nmodels and clinical triage, this guide\nprovides practical steps to improve clarity,\nreduce delays, and streamline the referral\nprocess.", "reading_order": 5 }, { "page": 1, "type": "TEXT", "location": { "l": 310.7061, "t": 703.5547, "r": 546.5548, "b": 668.041 }, "text": "Common issues identified during clinical triage include:", "reading_order": 6 }, { "page": 1, "type": "TEXT", "location": { "l": 309.7464, "t": 649.0844, "r": 554.9523, "b": 615.7303 }, "text": "Reason for referral unclear (Advice vs Referral)", "reading_order": 7 }, { "page": 1, "type": "TEXT", "location": { "l": 36.469, "t": 619.8096, "r": 268.2389, "b": 571.3382 }, "text": "A high-quality referral should allow\nsecondary care to make a decision without\nfurther clarification.", "reading_order": 8 }, { "page": 1, "type": "FIGURE", "location": { "l": 304.9478, "t": 597.7335, "r": 330.1402, "b": 561.5 }, "text": "", "reading_order": 9 }, { "page": 1, "type": "TEXT", "location": { "l": 333.979, "t": 596.0538, "r": 545.3552, "b": 542.7833 }, "text": "Attachments: Poorly labelled attachments, missing pages, photos not included.", "reading_order": 10 }, { "page": 1, "type": "TEXT", "location": { "l": 37.4287, "t": 569.8985, "r": 232.2498, "b": 555.0212 }, "text": "This guide will help GP practices:", "reading_order": 11 }, { "page": 1, "type": "TEXT", "location": { "l": 39.828, "t": 553.3415, "r": 255.2828, "b": 523.1068 }, "text": "Reduce the administrative burden of referrals", "reading_order": 12 }, { "page": 1, "type": "FIGURE", "location": { "l": 301.8288, "t": 528.1459, "r": 332.2996, "b": 496.4716 }, "text": "", "reading_order": 13 }, { "page": 1, "type": "TEXT", "location": { "l": 333.0193, "t": 524.3066, "r": 544.1555, "b": 470.0763 }, "text": "Long clinical histories or information\nnot relevant to specialty (e.g. 15+ pages)", "reading_order": 14 }, { "page": 1, "type": "TEXT", "location": { "l": 40.5477, "t": 520.7073, "r": 233.6894, "b": 490.2327 }, "text": "Improve constructive advice and guidance conversations", "reading_order": 15 }, { "page": 1, "type": "TEXT", "location": { "l": 41.2675, "t": 489.2729, "r": 199.3797, "b": 473.6756 }, "text": "Reduce referral rejections", "reading_order": 16 }, { "page": 1, "type": "FIGURE", "location": { "l": 63.1009, "t": 447.7603, "r": 90.4527, "b": 409.3671 }, "text": "", "reading_order": 17 }, { "page": 1, "type": "TITLE", "location": { "l": 101.4893, "t": 435.0425, "r": 383.1642, "b": 419.2053 }, "text": "How to make your referral clear and effective", "reading_order": 18, "level": 3 }, { "page": 1, "type": "TEXT", "location": { "l": 39.1082, "t": 406.7276, "r": 537.4376, "b": 391.1303 }, "text": "Use the conversation box and include a specific clinical question when requesting advice", "reading_order": 19 }, { "page": 1, "type": "TEXT", "location": { "l": 39.3481, "t": 388.4908, "r": 539.5969, "b": 372.1737 }, "text": "✓ Include all relevant clinical information, history, examination findings and current treatment\n✓ Attach investigations and tests before submitting referral, as we cannot always access investigations performed outside the organisation\n✓ Upload any attachments in pdf format when possible.\n✓ Name the Referral attachment as clear as possible e.g. ‘ENT Referral letter’ to enable the clinicians to find the referral quickly.\n✓ Indicate any additional needs that require a specific appointment type (e.g. deaf patients require face-to-face appointments or interpreters).", "reading_order": 20 }, { "page": 1, "type": "TEXT", "location": { "l": 39.588, "t": 368.8143, "r": 513.9247, "b": 335.7002 }, "text": "Attach investigations and tests before submitting referral, as we cannot always access investigations performed outside the organisation", "reading_order": 21 }, { "page": 1, "type": "FIGURE", "location": { "l": 41.0276, "t": 368.0944, "r": 54.7035, "b": 353.4571 }, "text": "", "reading_order": 22 }, { "page": 1, "type": "FIGURE", "location": { "l": 40.7877, "t": 334.9803, "r": 54.9434, "b": 318.1833 }, "text": "", "reading_order": 23 }, { "page": 1, "type": "TEXT", "location": { "l": 39.828, "t": 332.3408, "r": 342.8564, "b": 316.2637 }, "text": "Upload any attachments in pdf format when possible.", "reading_order": 24 }, { "page": 1, "type": "TEXT", "location": { "l": 39.828, "t": 313.1442, "r": 535.0383, "b": 279.3103 }, "text": "Name the Referral attachment as clear as possible e.g. 'ENT Referral letter' to enable the clinicians to find the referral quickly.", "reading_order": 25 }, { "page": 1, "type": "FIGURE", "location": { "l": 41.2675, "t": 275.9509, "r": 54.4635, "b": 261.0735 }, "text": "", "reading_order": 26 }, { "page": 1, "type": "TEXT", "location": { "l": 40.3078, "t": 275.7109, "r": 528.5602, "b": 241.637 }, "text": "Indicate any additional needs that require a specific appointment type (e.g. deaf patients require face-to-face appointments or interpreters).", "reading_order": 27 }, { "page": 1, "type": "TEXT", "location": { "l": 38.3884, "t": 238.2776, "r": 524.9613, "b": 203.7237 }, "text": "For Urgent Suspected Cancer referrals please include the Pan London form and inform patients we are investigating cancer.", "reading_order": 28 }, { "page": 1, "type": "FIGURE", "location": { "l": 65.7401, "t": 197.4848, "r": 98.6102, "b": 166.5303 }, "text": "", "reading_order": 29 }, { "page": 1, "type": "TITLE", "location": { "l": 100.7695, "t": 187.4066, "r": 364.4498, "b": 171.5694 }, "text": "How to avoid common causes of rejection", "reading_order": 30, "level": 3 }, { "page": 1, "type": "TEXT", "location": { "l": 41.5075, "t": 160.7714, "r": 414.8346, "b": 129.097 }, "text": "Select the correct service - Confirm via Directory of Services (DoS) that Homerton provides the service", "reading_order": 31 }, { "page": 1, "type": "TEXT", "location": { "l": 41.7474, "t": 127.8972, "r": 414.8346, "b": 96.7028 }, "text": "Please note: We are unable to easily refer to community services outside City and Hackney", "reading_order": 32 }, { "page": 1, "type": "TEXT", "location": { "l": 41.9873, "t": 95.263, "r": 269.4386, "b": 80.1457 }, "text": "Enable the option to convert to referral", "reading_order": 33 }, { "page": 1, "type": "TEXT", "location": { "l": 41.5075, "t": 77.9861, "r": 415.5544, "b": 46.3118 }, "text": "Do not use Advice and Guidance for waiting list queries, direct these to the appropriate admin team\nThank you to all the teams involved in the Task and Finish Group to develop this guide - The Heron Practice, Lower Clapton Group Practice, Spring Hill Practice, Homerton Trust Consultants and Admin team.", "reading_order": 34 }, { "page": 1, "type": "FIGURE", "location": { "l": 439.5471, "t": 158.8517, "r": 544.3954, "b": 64.7885 }, "text": "", "reading_order": 35 }, { "page": 1, "type": "TEXT", "location": { "l": 42.4672, "t": 35.5137, "r": 511.0455, "b": 10.0782 }, "text": "Thank you to all the teams involved in the Task and Finish Group to develop this guide - The Heron Practice, Lower Clapton Group Practice, Spring Hill Practice, Homerton Trust Consultants and Admin team.", "reading_order": 36 }, { "page": 1, "type": "FIGURE", "location": { "l": 515.6041, "t": 35.7536, "r": 546.5548, "b": 9.8382 }, "text": "", "reading_order": 37 } ] } ]