Rapid referral clinic


Rapid referral clinic (.pdf)

Cambridge out patient department management to reduce emergency admissions 

Started: 2006
Region: Cambridge
Geography: Urban 

Background / Motivation

  • Admission avoidance ( referred patients)
  • Less than two week wait access to a senior paediatric opinion for primary care professionals
  • One stop clinic: Detailed written management plans enhancing primary care knowledge of management


Rapid access to senior staff, avoidance of admissions to hospital where safe and appropriate. Developing parent info on common conditions. Linking in with community teams where appropriate. Successful, rapid response to an urgent medical problem. Admission avoidance. Safety net for those patients discharged home to have a senior early clinical review.

Target patient groups

Those requiring urgent rather than emergency referral and those where admission can be avoided but an early review the following day can be made

The service model

The model was instigated by the trust and paid standard OPD tariff with no formal commissioning. One stop appointment and allow senior review of a child sent home from ED the previous day that might otherwise have needed to stay. Patients seen by senior staff and decisions made, often without requiring hospital follow up

Opening times

Five clinics per week


Five consultants, one associate specialist and one senior SpR (Specialty registrar)

Who can refer

GP, HV, Midwife

Who is accountable for patients

Named consultant


Clinic space on in-patient ward

Funding organisation

Cambridge University Hospital Foundation Trust

Level of patient/family involvement

No recent PROM (patient recorded outcome measure)/PREM (patient rated experience measure) evaluation

Level of integration in the system

One stop, timely assessment and advice for primary care professionals


More than 6+ children per day

No recent PROM/PREM evaluation

Probably lowest conversion rate (ED attendances resulting in admission) and LoS (length of stay) for acute paediatrics in any of the hospitals in the East of England.

Challenges, successes, lessons learned and advice

Resources not keeping up with demand

Lack of formal evaluation apart from outdated satisfaction survey

Contact for more information

Peter Heinz/Helen Bailie/Ruth Clay, Cambridge University Hospital Addenbrookes Hospital


01223 245151


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