How Cinapsis helped save emergency care save £1.5 million

As part of the regional NHS strategy to improve urgent care access, Cinapsis has been an active partner across Gloucestershire since 2018, Bath, Swindon and Wiltshire since 2021. Working with local out-of-hospital teams to reduce unnecessary Emergency Department attendances and agreed ambulance conveyance routes. 

How it works 

Cinapsis is used as a digitally-led rapid referral process to enable dialogue between GPs, paramedics, NHS 111 call handlers, community clinicians and hospital specialists. Using the app or web-based platform, clinicians can securely discuss their patient’s case with the specialist, safely share clinical images and documents and together decide whether admission is necessary or if the patient can be managed out of hospital. 

For busy hospital specialists the benefits include: 

• The ability to respond to urgent care case queries requests asynchronously on their own phone with all information in structured templates reducing risk of missing data.
• Ease of sharing information with other specialists - as the system supports multi-speciality triage meaning queries can be re-routed or shared with another specialist instantly, rather than starting a new A&G referral.
• Having a documented decision trail with every interaction in an auditable record. 

Impact 

Through the use of Cinapsis in one ICB they converted emergency care referrals from primary care and ambulance services into planned care. 

Specifically the evaluation showed: 

• 83% of cases were managed outside the Emergency Department 
• 53% of patients were seen in specialist clinics
• 30% were managed in the community. 

From 24/25 data for one NHS Trust, this equates to 11,000 out of 12,500 cases and based upon the NICE unit cost of £144 for each ED attendance, this demonstrates a saving of £1.5M.  Most importantly, this has released very significant clinical capacity for those patients who urgently need emergency care.

An added benefit is that Cinapsis can integrate with third party systems, for example with SHREWD which provides secondary care teams and commissioners with essential insights into the demand for specialist advice pathways coming from primary care. This live visibility alongside Cinapsis enables clinicians and managers to co-ordinate and plan patient flow in accordance to change in activity demand.

Overall Cinapsis has improved system flow, reduced ambulance queues and also reduced overcrowding within the ED by redirecting avoidable cases to the best pathway or service for the patient. 

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