Introduction
The Northern Care Alliance (NCA) NHS Foundation Trust brings together staff and services from Salford Royal NHS Foundation Trust and The Pennine Acute Hospitals NHS Trust, delivering healthcare services to over one million people across Salford, Oldham, Rochdale, and Bury, as well as providing more specialist services to patients from Greater Manchester and beyond.
Northern Care Alliance NHS Foundation Trust
The Challenge
The Northern Care Alliance faced a significant administrative and operational challenge — approximately 1.1 million abandoned outpatient referrals sitting inactive in its referral management and patient administration systems. These dormant referrals had seen no activity for over 180 days, were unattached to outpatient waiting lists, and had no scheduled appointments. To safely address this backlog, the trust required a robust, scalable, and explainable data-driven solution capable of identifying and classifying each referral.
NHS Referral Management Planning
What We Did
In collaboration with our partner Keystream, and using open-source technology frameworks and open data standards, we built a vendor-agnostic, scalable, and extensible classification service to process each abandoned outpatient referral. The system placed each record into a defined risk category alongside a confidence score, providing clinical and operational teams with the insights needed to drive a human-led, safety-first closure process.
Keystream — Transforming the Public Sector
Key Outcomes
Our solution enabled the Northern Care Alliance to safely resolve its historic backlog of abandoned outpatient referrals while embedding safeguards to prevent future buildup. Built using open standards and frameworks, and governed by architectural principles — vendor agnosticism, scalability, interoperability, extensibility, and explainability — the solution is readily reusable across other NHS Trusts, regardless of local workflows, systems, or data models.