Rapid Access Clinic (FOI)

​Request

Re: Jersey General Hospital - the Rapid Access Clinic (RAC).

A

What is the purpose of the RAC?

B

When was it set up?

C

Please provide the guidelines / protocols / aims of the RAC?

D

Provide a list of the number of patients (not names) examined by the consultant of the RAC on 24 August 2021?

E

Who is currently the lead consultant of the RAC who examines patients?

F

Is Mr Samy currently a locum of RAC if not when did he leave the hospital?

G

Was Mr Samy the consultant examining patients of the RAC on 24 August 2021?

H

What are the normal working hours of the consultant on RAC eg 9am - 4pm?

I

How many consultants are allocated to examine patients of the RAC per normal working day?

Response

A

Rapid Access Clinics are for referrals triaged as urgent (to be seen within two weeks).

B

The service has been in place for at least five years. 

C

It is for assessment of new patients triaged as urgent (i.e. where the patient needs to be seen within two weeks), and for limited (one or two maximum) follow-ups of these patients.

Information extracted from the ophthalmology operational policy: 3.9.5.1 Rapid Access Clinic.

1. This clinic will run twice a week: Monday afternoon and Friday morning.
2. It is for assessment of new patients triaged as urgent (i.e., needs to be seen within two weeks), and for limited (one or two max.) follow-ups of these patients.
3. Routine new referrals are not permitted in RAC.
   
4. Soon new referrals should only be booked into RAC sessions if the session is grossly under booked (e.g., five patients or fewer).
   
5. Patients in RAC who require more regular or long-term follow-up should, after two RAC follow-up visits, be booked into a normal or sub-specialist clinic if appropriate, after discussion with the consultant in question if relevant. 
6. Follow-up slots in RAC are for patients seen in RAC to begin with; a RAC follow-up should not arise from a normal clinic visit.
7. For triage, RAC is only for patients requiring review in two weeks or less. Anything triaged to three to four weeks for example, should be accommodated in the normal clinics, even if as an overbook. This is to ensure that RAC remains accessible for emergency referrals up to and including the day of the RAC in question.
8. RAC must remain covered during doctor’s leave periods and is expected to run twice a week unless during periods of unusual leave or bank holiday concentrations such as the Easter and Christmas periods. If the regular clinician who covers RAC is on leave then a general clinic may need to be cancelled so a RAC can take place in that sessional slot. The clinic that may require cancelling is at the discretion of the department manager on discussion with the Clinical Lead, and needs to account for which clinic cancellation creates the least risk to patients and/or administrative burden.
9. Patients referred emergently to the RAC will be offered one appointment only, unless there are extenuating circumstances, e.g. Another simultaneous hospital appointment. Reasons of inconvenience (e.g., work commitments) will not be acceptable reasons for declining a RAC appointment in the context of the patient having been referred for an apparently urgent or semi-urgent medical condition.
10. If the patient is unable to commit to attend the RAC appointment being offered, a doctor (usually the doctor covering the RAC clinic in question or nearest RAC clinic) will be asked to dictate back to the referring clinician to inform them that the RAC appointment was declined, and a Soon priority clinic appointment can be made instead.
11. RAC referrals may be rejected by a doctor if insufficient clinical information (e.g., history or examination details) in order to triage the referral appropriately and confirm that the presentation requires urgent attention. If a doctor rejects an urgent referral for this reason, the nurse in charge (or another nurse with suitable experience) should telephone the referrer and/or patient and advise them that a new referral is required.

D

No RAC took place on the 24 August 2021.

E

The allocated on-call consultant is the lead consultant for the RAC, which changes according to the rota, however patients are seen by a dedicated middle grade staff member. 

F

The locum, Dr Samy, left on the 01 October 2021.

G

No RAC took place on the 24 August 2021.

H

RAC runs twice a week: Monday afternoon 14.00-17.00 and Friday morning 8.30-11.30. 

I

See point E.