The public is confused about what urgent care services exist and how to access them. We have unsustainable year on year growth in 999 calls and A&E attendances. There is huge variation in out-of-hour primary care services and management of demand/capacity for community services. Patients are experiencing multiple conversations, referrals, testing, and appointments before arriving at the most appropriate response to their need. Too many patients with long term or mental health conditions are not being properly supported to manage their conditions leading to repeat acute episodes that require emergency admission to hospital. Too many patients in the dying phase of an illness are taken to hospital because alternative provision which takes into account their wishes over place of death is not in place. All of this means we are not making the most efficient use of our NHS resources to best meet the needs of patients.
What we're doing:
Delivering the right care, given by the right person, at the right place and the right time:
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GPs will be geared up to do today’s work today and there will be more effective communication between primary care out-of-hours and emergency department teams
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We will have a comprehensive directory of services for urgent care so that we know exactly what services are available where and when and can refer patients to the right help, first time
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There will be excellent support for people to manage their long term or mental health condition as well as their end of life care needs
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There will be a simple to use and well publicised single point of access for patients.
Increasing the seniority of decision-making at critical points in the urgent care pathway:
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We will put the right-skilled and expert clinicians at the ‘front door’ to properly assess patients’ needs and decide on the best course of action
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We will have plans in place to work with and understand the needs of those who frequently attend our A&Es
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Our emergency departments will be more efficient and effective in their processes to manage the patients which come through their doors.
Reducing the length of hospital stay
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Patients will be given an expected date of discharge and the right systems and relationships will be in place with social care, primary care and community services to make sure this happens
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Services will be in place in the community to support the early discharge of patients.
How we're doing it:
There are three key elements to the work we are co-ordinating at a regional level:
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Clinicians working across urgent care have come together to develop a set of service standards and performance indicators which defines what the best urgent care systems are and monitors delivery of high quality care. You can find out more here.
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We have undertaken a peer review process of each health community to assess how they are transforming their local urgent care systems based on the regional standards which have been agreed. The final peer review report and associated documents are available to download on the right.
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We are pinoeering an urgent care dashboard for use by GP practices. You can find out more here.
