The NCL Interface Improvement Programme has been active for 2 years. Here is an update on the key priority areas. 

1. NCL Consensus document 

This has been in place since 2023 and has recently been updated.  It now incorporates the principles of the new Onward Referrals policy (previously called Consultant to Consultant Referral policy) and a flowchart developed to address concerns about the inappropriate transfer of tasks between primary and secondary care. The consensus document also aligns to the updated Interface Prescribing guidance due to be published shortly.

2. GP Feedback & Alert system 

The GP Feedback & Alert form is now the single, standardised route for raising concerns with secondary care and community services across NCL. It sits within EMIS and is designed to be quick to use, with automated tracking, reminders and escalation built in. More than 900 alerts have been submitted in the first 6 weeks. With a third of practices using the system, it is already giving a clear and structured view of interface challenges. Thank you to the practices already using it. Several internal improvements are being introduced to enhance escalation as well as improved provider engagement through thematic analysis.

3. Interface MDT meetings (UCLH & RFL)

Fortnightly interface  multi-disciplinary teams (MDT) meetings being held at University College London Hospitals (UCLH) and Royal Free London (RFL), bringing together medical directors, GP liaison teams, pharmacists and interface improvement leads. These meetings review real case studies to identify root causes and ensure learning leads to practical change. They also provide an opportunity for trusts to highlight challenges in correspondence from primary care, supporting improvement in both directions across the interface. The MDTs are increasingly focused on using data from the GP Feedback & Alert System to identify patterns and drive systemic improvement.

An example is that GP feedback highlighted an endoscopy nurse requesting GP prescribing following a procedure. This was reviewed at MDT and led to a change in process at UCLH, with prescribing redirected to gastroenterologists until nurse prescribers completed training.

4. Cardiology Task & Finish group

This group of clinical leads across primary and secondary care has agreed pathways on stable chest pain, atrial fibrillation, lipid management and palpitations and the new suspected stable angina form. Training is being arranged over next few months to share this widely.