Table 3 Perceived success of RMCs in relation to specified aims

Overarching aim:

Better use of resources

✓ (A1, A2, A3)

? (B1, B3)

- Too soon to draw conclusions

? (C2)

- Too soon to draw conclusions

✓ (D1, D3)

✘ (D1, D2, D3)- Commissioner not convinced by figures

Desired outcomes:

Improved quality of patient care

✓ (A1, A3, A5)

- Patients generally unaware

✘ (A2, A5)

- Occasional restricted choice for patients

- Concern about quality of community service provision

✓ (B2, B5)

- Community clinics offer convenience and shorter waiting times

✘ (B2, B3, B4, B6)

- Reduced patient choice

- Referrals sometimes get lost

✓ (C1, C2)

- Quicker referral times

- More time and information available to support patient choice

✓ (D1, D3)

- Patients unaware

- RMC highlights cases that should be upgraded to urgent

Reduced referrals to secondary care

✓ (A1, A2, A4)

- Up to 15 % reduction

✓ (B4)

- 8 % reduction

? (C2)

- Not a significant impact but too soon to tell

✓ (D1, D3)

✘ (D2)

- Commissioner not convinced by figures

Improved efficiency of referral process

✓ (A2, A3, A4, A5)

✘ (A1, A2, A5)

- Some duplication of work due to administrative glitches

- Teething trouble with IT/systems

✓ (B3, B6)

✘ (B1, B2, B3, B4)

- Some issues with under-capacity and turnaround times

- Some duplication of work

✓ (C1, C2, C3, C4)

✘ (C1, C3, C4)

- Some issues with under-capacity and turnaround times - Issues with booking management system

N/a

Intermediate outcomes:

Improved referral quality

✓ (A2, A3)

? (B1, B4)

- Believed to be reducing variability in referrals

? (C1)

- Anecdotally, fewer rejections from providers

✓ (D1, D3)

Diversion of referrals to alternative services

✓ (A2, A4)

✓ (B3, B5)

✓ (C3)

N/a

Reduced burden on GPs and practice staff

✓ (A4, A5)

✓ (B3)

✓ (C1, C2, C3, C4)

N/a

Process implementation:

Standardised referral processes

✓ (A2, A3)

Not mentioned in data

✓ (C1, C2)

N/a

GP education/culture change

✓ (A1, A3)

✓ (B2, B4, B5, B6)

✓ (C1, C2, C3, C4)

✓ (D1, D2, D3)

Implementing primary care pathways

✓ (A2)

✓ (B1)

✓ (C2)

✘ (D2)

- Did not effect pathway change as expected

Centralising referral/booking processes

Not mentioned in data

✓ (B4, B6)

✓ (C1, C2)

N/a

Providing up-to-date service knowledge

✓ (A1, A2, A4)

✓ (B1, B3)

✓ (C1, C2)

✓ (D3)

Informing service development

Not mentioned in data

✓ (B2, B4, B5, B6)

✓ (C1)

✘ (C2)

- Some concerns regarding data quality

Not mentioned in data

Data:

Collection and analysis of data

✓ (A2)

✓ (B2, B3, B4)

✓ (C3, C4)

✓ (D2, D3)