What is the e-Consultation service?

  • Enables primary care clinicians to request specialist advice from specialists in secondary care by sending an electronic message through SystmOne or ICE for Radiology.
  • Supports the appropriateness of out-patient referrals and ongoing primary care decision making.
  • Offers another option to a face to face out-patient referral.
  • 80% of requests receive a response within 2 working days for MYHT and 5 working days for LTHT.
  • Up to and including 3 Q&A per e-Consultation contacts, or exchange within a 4 week period for the same patient is allowable and chargeable at £23 to the CCG for a non-face-to-face National tariff.

Available Specialities

  • e-Consultation is currently available for the following specialties:
    • Cardiology
    • Diabetes
    • Endocrinology
    • Haematology
    • Hepatology
    • Gynaecology
    • Nephrology (Renal)
    • Ophthalmology
    • Paediatrics (Hospital)
    • Pain Management
    • Palliative Care
    • Radiology (via ICE)
    • Respiratory
    • Trauma & Orthopaedics
    • Urology

User Guides

Guidelines for Appropriate Use

Primary Care Good Practice

  • Consider/include the following areas before an e-Consultation request is sent:
    • Can a GP/clinical colleague in the practice support your clinical decision making?
    • Can OSCAR (Online Support and Clinical Advice Resource) or other online clinical resources support your clinical decision making?
    • In the request, information should be concise and relevant to the patient's current problem. The question being asked should be clear. References to specific investigations or letters will also help the receiving clinician navigate the SystmOne record.
When should an e-Consultation request be considered?
  • For advice on a treatment plan and/or the ongoing management of a patient in primary care
  • For specialist clinical advice
  • Beneficial for more challenging or complex cases
  • Queries regarding new treatments
  • Advice regarding appropriate testing and clarification of results
When should e-Consultation not be used?
  • Severe or acute cases where immediate advice is needed
  • To chase up an appointment
  • When pathway information is readily accessible on OSCAR
  • To send a full referral

Secondary Care Good Practice

  • Responding promptly
  • Being concise
  • Check relevant letters and results
  • Check the current medication list
  • Ask for more information if needed
  • Explain rationale for why a referral is required
Why might the secondary care specialist advise to 'Recommend for Referral'?
  • Too complex and therefore inappropriate for e-Consultation
  • When specialist examination/investigation/treatment needed

Respiratory Services

Assurance & Governance

  • This guidance was developed on: 03.2017
  • This guidance was ratified by: The OSCAR Assurance Group
  • Date ratified: 03.2017
  • Last updated:01.2018
  • Publication Date: 03.2017
  • Review Date: 03.2019
  • Ref No: SI3 - 03.2017
Any feedback or suggestions to improve this guidance should be sent to: oscaradmin@this.nhs.uk
Only the electronic version is maintained, once printed this is no longer a controlled document


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