Nervecentre V9.0 Help for Users
Progressing referrals after triage
Clinicians review or triage referrals to decide what happens to them. After triage, you can look at the clinician's review and progress the referral. You can accept, decline, or redirect the referral.
If the referral is accepted, you can book the patient's initial appointment, or add the patient to a waiting list for an appointment.
Progressing referrals after triage on a mobile
You can't do this on a mobile.
Progressing referrals after triage on a desktop
Viewing a clinician's review
Before you can progress the referral, you need to check the clinicians review to see what actions they requested.
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Find the patient, or the referral.
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From Outpatients > Patient Detail, search for the patient.
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From Outpatients > Worklists, find a worklist showing referrals that have been reviewed, and double-click on the referral.
The worklists available to you depend on your organisation.
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From Patient Detail > Patient admin > Show pathways > Referrals > Active Referrals, find a referral with the status 'Referral Review Complete'.
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Double-click on the referral to view the clinician's notes.
Check what action they asked you to do. For example, accept or decline the referral.
Accepting a referral
You can accept a referral before or after triage. If you accept a referral before triage, you skip triage.
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Find the patient, or the referral.
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From Outpatients > Patient Detail, search for the patient.
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From Outpatients > Worklists, find a worklist showing referrals that have been reviewed, and double-click on the referral.
The worklists available to you depend on your organisation.
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From Patient Detail > Patient admin > Show pathways > Referrals > Active Referrals, find a referral with one of the following statuses:
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'Awaiting triage'
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'Acknowledged, awaiting triage'
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'Referral Review Complete'
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Select the referral.
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Select Accept.
What happens next depends on if this is before or after triage.
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If this is before triage, a warning appears to say the referral has not been clinically reviewed. If you accept, you skip triage.
Follow your organisation's policies for when you can skip triage.
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If this is after triage:
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Select a specialty.
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Select a consultant.
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Select a priority.
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Select Accept.
The referral's status updates to 'Referral accepted, no activity booked'.
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Optional: to undo, select Undo Accept.
Declining a referral
You can decline a referral before or after triage.
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Find the patient, or the referral.
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From Outpatients > Patient Detail, search for the patient.
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From Outpatients > Worklists, find a worklist showing referrals that have been reviewed, and double-click on the referral.
The worklists available to you depend on your organisation.
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From Patient Detail > Patient admin > Show pathways > Referrals > Active Referrals, find a referral with one of the following statuses:
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'Awaiting triage'
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'Acknowledged, awaiting triage'
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'Referral Review Complete'
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Select the referral.
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Select Decline.
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Complete the form, including all mandatory fields.
Mandatory fields are marked .
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Select Decline Referral.
Depending on your organisation, and where the referral came from, you can send a letter about the declined referral to the patient's GP.
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Select a correspondence option to change who the letters are sent to.
To not send the letters, but record the form as completed, select None.
The options you see depend on your organisation.
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Select Click to preview letters.
The letters appear in your organisation's PDF viewer.
A list of letters appears on the right. This shows the recipient of each letter and how the letter is delivered. For example, 'GP - MESH'.
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Select Send.
The referral appears in Patient admin > Show pathways > Referrals > Completed Referrals.
The referral's status updates to 'Referral complete, declined'.
Redirecting a referral internally
You can redirect a referral to another specialty or site at your organisation.
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Find the patient, or the referral.
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From Outpatients > Patient Detail, search for the patient.
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From Outpatients > Worklists, find a worklist showing referrals that have been reviewed, and double-click on the referral.
The worklists available to you depend on your organisation.
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From Patient Detail > Patient admin > Show pathways > Referrals > Active Referrals, find a referral with one of the following statuses:
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'Awaiting triage'
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'Acknowledged, awaiting triage'
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'Referral Review Complete'
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Select the referral.
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Select Redirect.
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Select a specialty.
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Select a consultant.
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Select a hospital site.
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Select a priority.
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Select Redirect.
The referral's status updates to 'Awaiting triage'.
A clinician in the other specialty must triage the referral.
Transferring a referral to a different consultant
After you have accepted a referral, you can transfer a referral to a different consultant with the same specialty.
This only updates the name of the consultant that displays next to the referral and episode of care. Nervecentre doesn't send any letters or change any appointments when you do this.
If you want to change the specialty and the consultant, redirect the referral.
Read about redirecting a referral
To transfer a referral to a different consultant:
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Open the patient's record.
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If the patient has an appointment booked, select Outpatients > Clinic List > double-click on the patient's name > Patient Detail.
Depending on your permissions, you might need to select Go to patient record.
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If the patient doesn't have an appointment booked, from Outpatients > Patient Detail, search for the patient.
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From Patient Detail > Patient admin > Show pathways, select Referrals.
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From Active Referrals, select an accepted referral that has a consultant associated with it.
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Select Transfer Consultant.
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Select a consultant.
You can only choose consultants for the referral's specialty. You can't change the specialty here. If you want to change the specialty and the consultant, redirect the referral.
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Select Transfer.
Adding a patient to a waiting list
After you have accepted a referral, you can add the patient to a waiting list. You can add a patient to any waiting list, except waiting lists for procedures.
Before you can add a patient to a waiting list for a procedure, you must list a procedure.
Read about adding a patient to a waiting list for a procedure
To add a patient to a waiting list:
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Open the patient's record.
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From Outpatients > Patient Detail, search for the patient.
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From Inpatients > Patient Detail, search for the patient.
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From Patient Detail > Patient admin > Show pathways > Referrals > Active Referrals, find a referral with the status 'Referral accepted, no activity booked'.
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Select the referral.
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Select Add to WL.
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From Choose Waiting List, select the waiting list you are adding the patient to.
A form appears. What appears in the form depends on your organisation.
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Complete the form, including all mandatory fields.
Mandatory fields are marked .
Select fields to edit them.
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Select Add to Waiting List.
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Select a correspondence option to change who the letters are sent to.
To not send the letters, select None.
The options you see depend on your organisation.
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Select Click to preview letters.
The letters appear in your organisation's PDF viewer.
A list of letters appears on the right. This shows the recipient of each letter and how the letter is delivered. For example, 'GP - MESH' or 'Patient - Manual print'. To view a letter, select view.
You can also see information about the patient's preferred method of receiving letters, and preferred letter format.
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Depending on your permissions, if Nervecentre is sending a patient's letter by the patient's preferred delivery method, by Docmail, or by email, you can choose to manually print and send the letter instead.
To manually print and send a patient's letter, select Prevent sending of this letter, I will manually print it instead.
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Select Send.
The referral's status updates to 'Referral accepted'.
A waiting list entry appears in Patient admin > Show pathways > WL > Active Waiting List Entries.
Booking an initial appointment
After you have accepted a referral, you can book an initial appointment.
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Find the patient, or the referral.
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From Outpatients > Patient Detail, search for the patient.
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From Outpatients > Worklists, find a worklist showing accepted referrals with no appointment booked, and double-click on the referral.
The worklists available to you depend on your organisation.
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From Patient Detail > Patient admin > Show pathways > Referrals > Active Referrals, find a referral with the status 'Referral accepted, no activity booked'
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Select the referral.
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Select Book NEW appt.
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Select the type of appointment.
For example, initial consultation.
A form appears.
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To choose dates the patient asked you to avoid, select Avoid dates.
For example, a patient might tell you when they are going on holiday.
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To choose an appointment time, select Appointment slot.
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Complete the form, including all mandatory fields.
Mandatory fields are marked .
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Select Confirm appointment.
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Select a correspondence option to change who the letters are sent to.
To not send the letters, select None.
The options you see depend on your organisation.
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Select Click to preview letters.
The letters appear in your organisation's PDF viewer.
A list of letters appears on the right. This shows the recipient of each letter and how the letter is delivered. For example, 'GP - MESH' or 'Patient - Manual print'. To view a letter, select view.
You can also see information about the patient's preferred method of receiving letters, and preferred letter format.
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Depending on your permissions, if Nervecentre is sending a patient's letter by the patient's preferred delivery method, by Docmail, or by email, you can choose to manually print and send the letter instead.
To manually print and send a patient's letter, select Prevent sending of this letter, I will manually print it instead.
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Select Send.
The appointment appears in Patient admin > Show pathways > Appts > Booked Future Appointments.
The appointment's status is 'Appointment booked'.
Cancelling a referral or discharging a patient
You can cancel accepted referrals. When you cancel a referral, you record the outcome of the referral.
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Find the patient, or the referral.
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From Outpatients > Patient Detail, search for the patient.
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From Outpatients > Worklists, find a worklist showing accepted referrals, and double-click on the referral.
The worklists available to you depend on your organisation.
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From Patient Detail > Patient admin > Show pathways > Referrals > Active Referrals, find a referral with the status 'Referral accepted, no activity booked' or 'Referral accepted'.
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Select the referral.
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Select Cancel/Discharge referral.
A form appears. This shows:
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The current RTT status of the referral
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Any booked future activities related to the referral
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The clinical outcome
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Any procedures related to the referral
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From Outcome, select an outcome.
More options appear. These options depend on the outcome you chose.
- Select options until Continue appears.
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Select Continue.
What appears next depends on the options you chose.
One of the following appears:
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Future Activity
You must decide what happens to other activities related to the referral. For example, internal referrals, appointments, and waiting list entries.
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Actions Taken / Required
Shows any actions Nervecentre has automatically done. For example, added the patient to a PIFU list or waiting list.
Shows any actions you need to do before you can record the outcome. For example, list a procedure, or book an appointment.
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No Actions Required
Appears when you don't need to anything other than record the outcome.
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Select Complete Outcome.
The referral moves to Completed Referrals and the referral's status updates to 'Completed'.
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