Sussex Integrated Urgent Care Transformation. Autumn 2017

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1 Sussex Integrated Urgent Care Transformation Autumn 2017

2 NHS England The national specification requirements This service specification supersedes the previous commissioning standards, moving from an advisory set of recommendations to mandatory requirements, to ensure a consistent service across the country. GP Out of Hours and NHS 111 services will be combined, and multidisciplinary clinicians added to the integrated working model.

3 The nine key outcomes of Integrated Urgent Care 1. A single call to get an appointment during the out-of-hours period. 3. The capacity for NHS 111 and urgent multidisciplinary clinical services need to be jointly planned. 5. Care plans and special patient notes are visible to the Clinicians in the IUC and in any downstream location of care. 7. There is joint governance across Urgent and Emergency Care. 2. Data and Information can be shared between providers. 4. The Summary Care Record (SCR) is available in the Clinical Assessment Service (CAS) and elsewhere. 6. Appointments can be made to in-hours and extend access primary care services - offering services in the evening and at weekends. 8. Suitable calls are transferred to a Clinical Assessment Service containing GPs and other health care and social care professionals. 9. The Workforce Blueprint products and guidance are implemented across all providers.

4 Direct Booking In Hours The Sussex the NHS 111-Clinical Assessment Service will not make direct appointment bookings into GP Practices, in hours (8.30am 6.30pm). This is because of the current General Medical Services (GMS) contract or more specifically the GMS funded appointments and the added increase in patient volumes. Any calls to NHS 111-Clinical Assessment Service in hours (8.30am-6.30pm) will signpost to their GP Practice first. There will be other primary care services available in hours, such as Urgent Treatment Centres or Primary Care in A&E that the NHS 111 service will be able to make booking to if it s needed or required. If there is an area or location across Sussex that doesn t have an alternative option, such as an Urgent Treatment Centre then a GP Practice or collaboration of GP Practices may want to offer the ability for NHS 111-Clinical Assessment Service to make direct appointments into them. This will need to be a commissioned service and will not be forced on to our local GP Practices.

5 A Clinical Assessment Service SPECIALIST SERVICES HEALTH CARE PROFESSIONALS IN THE COMMUNITY EMERGENCY DEPARTMENTS 999 Health Advisor Clinical Advisor ALLIED HEALTH PROFESSIONALS GENERAL PRACTITIONER DENTAL NURSE PHARMACIST ADVANCE NURSE PRACTITIONER THE CLINICAL ASSESSMENT SERVICE SPECIALIST & ADVANCED PARAMEDICS MIDWIFE COMMUNUTY PSYCHIATRIC NURSE ED CLINICIANS PAEDIATRIC NURSE PALLIATIVE CARE NURSE SPECIALIST SUB-GROUPS RENAL SPECIALIST PATHOLOGY SPECIALIST CANCER SPECIALIST PSYCHIATRIC SPECIALIST TRANSPLANT SPECIALIST FACE TO FACE OUT OF HOURS GENERAL PRACTICE DENTIST MENTAL HEALTH CRISIS TEAM COMMUNITY PHARMACIST DIRECT APPOINTMENT BOOKING VIDEO CONSULTATION SELF CARE

6 What do we already know? Calling NHS 111

7 What do we already know? GP Out of Hours

8 What do we already know? Peak call times

9 Digital Principles Access to appropriate Patient Information Call handling tools and information Directory of Services Direct Booking into appropriate settings Remote access and virtual working Online Information Symptoms and Services Workforce management Clear reporting demand management and measurement of outcomes

10 Workforce Principles Workforce blueprint Use of all types of clinicians not just GP s 111 / Clinical Assessment Service Career Framework to develop HCP Avoiding duplication in the system and using existing resources Allowing flexibility especially to address demands Indemnity Insurance Clinical Governance for Quality and Development

11 This summers engagement activity Soft Market Testing Event 26 July 2017 We shared our initial thinking for the pan-sussex NHS 111 / Clinical Assessment perspective providers and the aim of integrated Urgent Care services across Sussex The Sussex wide NHS 111 Survey Service with We ve ran a survey online and printed in newspapers across Sussex throughout July and August to get peoples views and to use them to inform the service we are looking to buy PPG and Public Engagement Events Throughout August we attended a range of PPG meetings and public engagement events through the seven Sussex CCG s engagement teams. Staff and Clinical Engagement Throughout July and August we have been updating and engaging with CCG staff and their clinical membership on the progress programme.

12 Our survey said The survey was run from 17 July to 20 August We asked people a range of questions about the current service and their experiences. We also asked what people would like to see change to help inform the new services we are looking to procure for 1 April 2019.

13 Who did we hear from?

14 Who did we hear from?

15

16 Feedback on the current NHS 111 service

17 Feedback on the current NHS 111 service

18 Existing services rated on importance

19 Feedback on ideas for the future service

20 Feedback on ideas for the future service

21 Feedback on ideas for the future service

22 Feedback on ideas for the future service

23 Key Issues Raised So Far Technology Lead and development Workforce development HEE and Clinical Development Workforce blueprint Workforce Impact Indemnity insurance for GP s and Paramedics How does this connect to HSCC? Patient Engagement Direct Booking GP Surgeries Contract Length

24 Next Steps and Proposed Timeline

25 Timeline September July 2018 Governing Body sign off Setting up the public member network Internal and partner engagement Contract awarded - mobilisation starts Stakeholder Event Public Campaign - you said, we re doing Clinical Engagement Second soft market testing event PQQ process runs ITT Process runs

26 The Recommendations Recommended Procurement Process: Due to time and resource limitations we are proposing a Pre Qualification Questionnaire (PQQ) and Invitation To Tender (ITT) Procurement process with this procurement. Recommended Contract Length: Following the feedback from our first soft market testing event we are proposing a longer contract option than is normally considered. For this service we are recommending a five year contract with a two year extension option. Cost: We are looking at a contract value of approx. 17 to 19million per annum for the whole of Sussex. This figure currently includes the face to face element of Out of Hours

27 Questions?

28 Transformation Programme Team Colin Simmons, Programme Director Sussex 111 Transformation Programme Kerry Exley, Senior Project Manager Sussex 111 Transformation Programme Nicola Kemp, Senior Communications & Engagement Manager Sussex 111 Transformation Programme Morven Banks, Senior Commissioning Manager Sussex 111 Contract Team Dawn Fourniss, 111 Programme Support Officer Sussex 111 Transformation Programme Vinny Hanley, Directory of Services & Project Manager Sussex 111 Contract Team You can contact the team on:

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