Feedback very positive:
RightPath ‘well liked’ by parents/patients at both pilot sites with no complaints or requests for subsequent specialist referral; 99% ‘would’ recommend the service to family and friends and satisfaction scores were high;
'Listened to things that matter most to you about your/your child health' (mean rating 8.9/9, range 8-9)
'Included what matters most to you in choosing what to do next' (mean rating 8.9/9, range 6-9)
'Helped understand your/your child's health issues' (mean rating 8.8/9, range 7-9)
Service providers (primary care physiotherapists & podiatry) described the workload to be appropriate for their existing professional skills. Those triaged to their care were reported to be a similar case mix to their regular clinical practice and no concerns were expressed by families receiving their care.
Triage staff deemed the triage process ‘manageable’ (63% of decisions ‘easy/very easy’) and the triage guidance to be useful commenting that paediatric experience is important to decision-making. Some triage decisions were reported as being challenging due to either clinical complexity of the referral and / or the quality of referral letters with key information being missing.
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“Originally I wanted to see really a specialist but by the end of the consultation with the physio I felt like it wasn’t necessary and he really, yeah he went through all the tests and was very thorough and he identified the problems and what we had to work on from a physical point of view” (Parent).
“The majority of the ones we see are, what we'd class as, normal walking variants anyway, so things like intoeing and hypermobility and flat feet. Yes, there's the odd one that you think might be a bit more complicated than that, but generally I would say it was business as usual for us” (Service Provider).
“At times challenging, but I think that’s because we’re not paediatric trained, rather than the processes...I was just apprehensive because it was children” (Adult MSK Nurse commenting on the triage process).
“We do know that children are being referred, like we've said, in duplicate to different services, or they're being referred to a paediatrician when they don't need to be. So I do think it's a good idea. So if we can get the children to the right services then that would be better for everybody” (Service Provider).
“I think because paediatrics is very, very different to the adult work you see things that you just would never come across in the adult world, certainly, and there are lots of different conditions that are very specific to Paediatrics that you just don’t ever see or that you wouldn’t ever come across as an adult clinician (Podiatrist/Physiotherapist with paediatric experience commenting on the triage process).
“There have been no problems. The parents, as well as the children, have been happy with the consultation and the treatment plans, and I think, although they might have been initially told by the GP that they were going to be seen by a consultant, or the orthopaedic team, they didn’t really expect that, as such. Nobody said, ‘Oh, well, I thought I was seeing a consultant. How come I’ve come here when I should have been going to the hospital’” (Service Provider).
“Lovely treatment and service today. She [physio] was lovely and patient with my little boy. Very understanding especially as he wanted to play rather than get examined” (Parent).
“We do this work day in, day out. We’ve been doing it for 15 years, so it’s what we would expect to come through our doors” (Service Provider).
“I think sometimes there’s not enough information on the letter... so then you looked at your triage criteria and all the questions it was asking we can’t answer because there’s no information on the letter, so that was a bit difficult” (Triager).
“The more information you have the more likely you know what avenue to take” (Triager).
“GP - Appointment referral time very quick. Appointment itself was quick and efficient, reviewing the issue and solution thoroughly” (Parent).
“Its one of those things, in theory where you wonder why it’s not in place anyway. Good triage at the source should make everything work a little bit more efficiently” (Service Provider).
“Was great with my daughter and explained her development well” (Parent).
“There’s nobody that I’ve seen who I felt would have needed escalating, further than seeing myself” (Service Provider).
“I much preferred being seen in the community rather than a hospital environment” (Parent).
“I suppose with the patients that come through to us, because the conditions are what we do routinely anyway, it’s very easy for us to explain what’s going on. We’re used to that. That’s one of our skills, I suppose, understanding how to discuss it with the kid, as well as with the parent” (Service Provider).
“It’s just the level of information that’s in there – why the child has been referred, a good history of what’s been going on, and what has already been ruled out. So, if the GP has already done any assessment themselves, what have they done? If they’ve done any other tests, what have they done? All of that kind of thing makes the triaging process easier because you’ve got all the information to hand. The ones that aren’t very clear are just the ones that have very, very little information in them, so it’s hard to see” (Triager).
“The treatment received today was very good! It exceeded my expectations as was very friendly, listened to me and made me feel comfortable” (Parent).