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Your spotlight on local services

Clinical Assessment and Peer Review (CASPeR) pilot programme


The CCGs had commissioned a Clinical Assessment and Peer Review (CASPeR) pilot programme across Darlington, Hartlepool and Stockton-On-Tees locality areas which aims to reduce inappropriate variation in GP referrals and ensure that patients are seen and treated in the right place, first time.

Demand for elective care services is continuing to grow and more patients are being referred for treatment than hospitals are able to treat. This is leading to an increasing waiting list and longer waiting times for patients. Analysis of activity across the Hartlepool and Stockton-On-Tees and Darlington locality areas shows variation in the number of patients being referred to hospital outpatients. It is recognised that, for some referrals, patients could be managed differently without having to be referred to a hospital for treatment. The Clinical Assessment and Peer Review (CASPeR) pilot process aims to support us as commissioners to establish services which will not only reduce demand on secondary care services, but also improves patient experience.

Clinical Assessment and Peer review (CASPeR) sees GPs reviewing each other's new routine (non-urgent) referrals to provide constructive feedback in a learning environment. Reviewing before referral will deliver real-time qualitative benefits in referral quality, experience for patients, ensuring that all options are explored and that patients are treated in the right place, at the right time and as quickly as possible.

Establishing this process other than a standard Referral Management Centre approach seeks to create sustainable changes across our localities through knowledge sharing, education & training. The pilot commenced with four specialty areas in August, with a further four specialty areas introduced in September. Following the successful introduction of CASPeR, a decision has been made to add an additional four speciality areas. These include; General Surgery, Respiratory, Elderly Medicine and Neurology.

The CCG will continue to regularly monitor this pilot to ensure it delivers the expected improvement outcomes and to determine any future commissioning arrangements.

For your information, we have enclosed a copy of the updated patient leaflet that has been developed to support GP practices in describing the process to patients, should they require any further information. This has been developed based on best practice from other areas and has taken into consideration feedback from local practices and relevant LMC groups. Practices also have access to an updated poster to display in their centres and patients will be supported with any queries they may have about the pilot programme.