CASES stands for Clinical Assessment, Support and Education Service. It is an elective care re-design programme that aims to make sure that patients in Sheffield receive their care in the most appropriate setting from the most appropriate clinician. CASES began as a pilot in July 2016 and involves a partnership of NHS Sheffield Clinical Commissioning Group (CCG), Primary Care Sheffield (PCS) and Sheffield Teaching Hospitals (STH).

The programme covers ten specialties:

Cardiology
Dermatology
Ear Nose and Throat
Gastroenterology
General Surgery
Gynaecology
Haematology
Neurology
Respiratory
Urology.

A team of Sheffield GPs who have additional training and mentoring from hospital consultants in the ten specialties provide support and guidance (peer review) to GPs when they think a patient may need to be referred. Sometimes the patients may not need to go on to hospital and can be treated by their GP with appropriate advice and guidance, or additional tests or information may be suggested to help diagnose the patient when they attend the hospital. This helps to ensure that patients who can be treated by their GP receive the help they need closer to home without needing to go to hospital.

The learning from what conditions are commonly referred and how they can be treated is then shared with GPs across the city and used to develop education resources and guidance. It is also used to inform changes to the pathways for treating different conditions and to inform planning decisions for services.

How does it work?

Referrals (except for urgent cases) in the ten specialties listed above are made by the patient’s practice via the Electronic Referral Service (ESR), to the CASES team at PCS. Referrals are then peer reviewed by a GP who has received mentoring and support from specialist consultants from Sheffield Teaching Hospitals Foundation Trust.

The referral is then either forwarded to the hospital, or advice is returned to the GP to consider managing the patient by other means. This process takes no more than 3 days, in order to minimise delay.

If the referral is forwarded to the hospital, the patient will then receive information for their appointment.

Want to find out more? The short videos below explain how the referral system worked before CASES was introduced, why this wasn’t sustainable and how CASES addresses the problem.