Process improvements and time savings

The challenge

The respiratory team at the Royal Oldham Hospital wanted to improve the referral process and response time for inpatient referrals. At the time, the process was manual and paper based.

Therefore, this required administrative staff to manage incoming referrals and distribute them to clinicians in hard copy. There was also no adequate method to manage referrals electronically or to ensure that all referrals were dealt with in a suitable timeframe.

There were multiple referral methods, such as telephone calls and electronic forms, being used by different teams for inpatient respiratory referrals.

As a result, administrative staff had to manually collect referrals, gather missing or additional information. They then had to distribute them in hard copy format to the clinical team.

Therefore, adding time and process steps, resulting in referral delays and an increased risk of referrals being easily lost or overlooked.

Nurse on table device


Bleepa® was introduced as a pilot to manage inpatient referrals to the respiratory team in December 2019.

The initial pilot was evaluated in January 2020, leading to further development and expansion of the pilot to include referrals from the Acute Medical Unit (AMU). Then in March 2020, the pilot was paused due to the coronavirus pandemic. However, Bleepa® was identified and reintroduced as a tool to support the tracking of known and suspected COVID-19 patients.

By June 2020, as the number of COVID inpatients began to decline, the team was keen to explore how the additional functionality implemented as part of the COVID pathway, with all the lessons learned, could be applied to the original proof of concept.

The goal was to demonstrate how Bleepa® enables clinicians to remotely view and discuss clinical grade patient images directly from the hospital’s PACS. At the same time as incorporating referral workflow into Bleepa®, streamlining the referral process and generating clinical efficiencies.

Outpatient department sign in NHS car park


The implementation of Bleepa® has streamlined the respiratory referral workflow by ensuring a single point of access for inpatient specialist referrals. In addition, the use of Bleepa® has standardised the referral process to include greater clinical detail, informing clinical decision making and collaboration.

In real-time, clinical teams can view their inpatient referral pipeline, triage, communicate about and action referrals from all sources using Bleepa®. Furthermore, the status of referrals can be more closely monitored by all clinicians involved in the case. Therefore, reducing the likelihood of a referral being overlooked. By implementing an electronic means of referral, the need for administrative staff to manually process referrals has been removed, freeing them up to do other tasks.

Survey results with staff using Bleepa at the Northern Care Alliance from independent evaluation

Key findings – Unity Insights independent report

Feedback Medical commissioned Unity Insights – a research and insights company – to conduct a real-world evaluation, using historical data and forward-looking economic modelling.

The evaluation was composed of quantitative data covering 10,000 patient referrals from two trust sites where Bleepa® has been in use.

Referral response times

  • Within the respiratory specialty it took 0.28  days on average for a referral to receive a response. This is a decrease of 87% from the 2.1 day average identified in a previous study (Beattie, 2020)
  • Bleepa® referral data from July 2021 to April 2023 found that the average time from submission of a referral to first review across the trust’s respiratory, cardiology and gastroenterology. specialisms was 0.55 days. This was a reduction of 1.55 days (74%) compared to the 2.1 day average time lag recorded before the platform’s deployment at NCA.