Strategy for Delivery of Clinical Quality and Patient Safety. North Norfolk Clinical Commissioning Group

Transcription

1 Strategy for Delivery of Clinical Quality and Patient Safety North Norfolk Clinical Commissioning Group V5

2 Document Control Sheet Name of document: Quality Strategy Version: 5 Owner: Head of Clinical Quality and Patient Safety File location / Filename: Date of this version: February 2016 Produced by: Synopsis and outcomes of consultation undertaken: The Clinical Quality and Patient Safety team No adverse impact identified Synopsis and outcomes of Equality and Diversity Impact Assessment: Approved by (Committee): Date ratified: Copyholders: Next review due: 2018 Enquiries to: Revision History Revision Date Summary of changes Author(s) Version Number 07/04/16 Review of format and overall content and context JS 3 Approvals This document requires the following approvals either individual(s), group(s) or board. Name Title Date of Issue VersionNumber V5

3 Contents Page Foreword 4 Introduction 6 National Context 6 Local Context for North Norfolk 7 North Norfolk Clinical Commissioning Group; Our Ethos 8 The Framework by which we will Monitor Quality 8 Safety Thermometer 10 Quality Surveillance Group 10 Commissioning for Quality and Innovation (CQUIN) 10 Quality Accounts 11 Quality, Innovation Productivity and Prevention (QIPP) 11 Reporting System 12 NNCCG Clinical Commissioning Group Quality and Safety 12 Structure (internal assurance) Quality Strategy Implementation 14 Appendices 1. Integrated Care and Transformational Change Model NNCCG Quality and Safety Performance Reporting Routes NHS Outcomes Framework Glossary 18 V5

4 Foreword North Norfolk Clinical Commissioning Group (NNCCG) is a clinically led organisation, which means that it is made up of Local Doctors, Nurses and other professionals. We are responsible for identifying the health and care needs for the people of North Norfolk along with planning and commissioning (buying) the best available health services for our patients, whilst also working to improve the health outcomes of our local community. It is a membership organisation with representatives from the 19 GP practices across North Norfolk, and it is they who lead the decision making about which services and service changes are required to meet local population needs. As a CCG, we inherently believe that, at all times, the care and treatment afforded our patients should be safe, of the highest quality and reliable, and as an organisation it will be our prime focus and commitment to ensure that this is delivered. This revised strategy reflects the progress, we as a CCG are making in developing systems which support better identification and measurement of quality and safety that is both meaningful and deliverable for our patients. Over the previous 3 years we are pleased to reflect upon the positive changes that we and our providers are making to improve the experience of our patients. There is a greater awareness of, and a reduction in, avoidable harms such as pressure ulcers, falls and early identification and treatment of avoidable infections, and a notable reduction of Healthcare associated infections such as Clostridium Dificile. We aim to continue to promote the work in these key areas to further drive improvement of care and patient outcomes in the coming year. As we move towards the joint responsibility for commissioning Primary Care in 2016/17 we look forward to supporting our Practice members to become even more involved in identifying quality improvements within their own services and across our locality. Our Strategic quality priorities for the next three years will focus on: Promoting strong clinical leadership across services and ensuring adequate staff with the right skills to deliver high quality and safe care. Ensuring that our patients with learning disabilities have the opportunity to receive safe, supportive and least restrictive care within the community where ever possible, and that any hospital admissions are appropriate and line with the recommendations from the Transforming Care agenda. To work with our Practices, community care teams and social care services in developing more integrated and aligned support leading to more timely access to care in the right place and at the right time thereby improving patient outcomes. Working with our local Care home sector to agree what good care looks like and support the development of clinical pathways that will help to raise the bar around skills, competencies and training outcomes for staff, which in turn will support better outcomes for patients. Developing a programme of support for our primary care colleagues to meet the ongoing challenges of the changing health needs of our local population. 4

5 2016/17 will be a financially challenging time for North Norfolk CCG requiring us to make difficult decisions around the services that we commission, however we resolve to ensure that at all times our first and main consideration will be to retain safe and high quality services as our priority, and, by working with our Community Engagement Panel (section 6.2) we will ensure that we look for the support, guidance and feedback from the wide ranging network of patient groups that are represented through the panel to ensure that patient choice and experience is an integral part of our commissioning processes. Dr Anoop Dhesi MA MB BChir DCH MRCGP GP Principal, Staithe Surgery, Stalham, Norfolk NR12 9BU Chairman, North Norfolk Clinical Commissioning Group 5

6 1. Introduction 1.1 In 2013 North Norfolk Clinical Commissioning Group (NNCCG) developed its first Quality and Patient safety Strategy which identified the vision and ethos of the newly established organisation along with our plans for monitoring and assessing the quality, safety and effectiveness of our commissioned services. 1.2 It is intended that this revised strategy for 2016/18 will reflect the changing landscape of the NHS, the additional responsibility around joint commissioning of primary care and our organisational learning and maturity. It also demonstrates the high level of commitment from NNCCG towards driving quality improvements, better monitoring and application of patient outcomes to inform our commissioning intentions and the management of quality within our contracts which aim to achieve improved patient experience and satisfaction. 1.3 Quality can mean very different things to different people and it is important to define the term in order to enable a clear baseline for expectation. A definition of quality within the NHS is set out by Lord Darzi (DoH 2008). Care that is clinically effective based upon the best and most recent evidence and is likely to improve health outcomes. Care that is safe and reduces the risk of harm. Care which provides a positive experience for patients, is in line with their wishes and ensures they are treated with dignity, compassion and respect. 1.4 These simple points ensure that patients are placed centrally to the planning and delivery of care and treatment and as such NNCCG will apply this definition of quality, both for this strategy and as the framework by which we will monitor services and look continually to improve the care and support that our patients receive. 1.5 This Quality and Safety Strategy forms a core component of our Operational Plan supporting the aim to deliver integrated services, placing patients at the heart of all we do and leading clinical service transformation to achieve better outcomes and efficacy across primary, secondary and urgent care, mental health services, Children s & Maternity Services and Continuing Healthcare. 2. The National Context (external assurance) 2.1 Clinical Commissioning Groups have a responsibility to provide high quality healthcare that is both equitable and accessible for all, as outlined in the NHS Constitution. The Constitution is enshrined in law and we are committed to upholding its rights and pledges and delivering against its standards. Under the Constitution, the rights of the patient, public and staff are clearly outlined. 2.2 The NHS Outcomes Framework (NOF) sets out the national outcomes that all providers of NHS funded care should contribute towards. Indicators in the NHS Outcomes Framework are grouped around five domains, which set out the high level national outcomes that the NHS should be aiming to improve. (Appendix 3) 6

7 2.3 The Care Quality Commission (CQC) both regulates and registers providers of health and social care. Quality care cannot be achieved by inspection and regulation alone. The main responsibility for delivering quality care lies with care professionals, clinical staff, providers and Commissioners. The inspection process considers compliance against a range of quality standards, and thereby a route by which providers and commissioners can monitor and improve quality and safety outcomes. The information produced through CQC inspection will be utilised by NNCCG to monitor and inform the level and type of input and overview the CCG should be directing towards specific providers of NHS commissioned services, while sharing and escalating issues or areas of concern with CQC in relation to our intelligence around provider performance. 3. Local Context for North Norfolk 3.1 The national demographic health profiles published by Public Health England identify better health outcomes and access to health care services for the people within North Norfolk. These profiles identify that: Life Expectancy is higher than the National average (80.4/78.9 males; 85.1/82.9 females.) Deaths from the most common causes such as cardio vascular disease and cancer for people aged under than 75 are amongst the lowest 25% in England. Approximately one third of the population of North Norfolk District Council is aged over 65 and the predictions are that this will increase to 42% by Deprivation is lower than average, however it is believed that approximately 2,500 children live in poverty within our locality. 3.2 Challenges for health commissioning within the locality are: An older population living longer often with at least one long term condition A large rural area with poor transport infrastructure making access to services difficult requiring the need to deliver more care at, or closer to home Unwarranted variation in health status and outcomes in parts of the locality particularly for young people A time of economic constraint and the need to prioritise resources equitably within the allocated cost envelope. The number of inquiries and reviews of the older persons care provision undertaken nationally identify the vulnerability of patients when receiving treatment within hospital. In light of our demographics the safety and welfare of our population whilst receiving care and treatment within acute settings will be one of the highest priorities for NNCCG; however monitoring good access to high quality community services is of equal importance to ensure early intervention and prevention of ill health and that unnecessary hospital admission is of high importance. 7

8 4. North Norfolk Clinical Commissioning Group; Our Ethos 4.1 NNCCG is committed to listening to feedback from our patients and service users, and by working with all of our providers of NHS healthcare will ensure that patients receive the best possible care, have a positive experience and are treated safely with dignity and respect. NNCCG aspires to develop an open and transparent culture. This will ensure that the services we commission are monitored and supported to embed necessary service improvement initiatives that will raise the standards of care and support. We will look to the work currently taking place within Kings College in relation to the Cultural Barometer to assist us in identifying those key attributes conducive to delivering compassionate patient centred care to inform the commissioning cycle and service development. 4.2 Our Values We believe that our patients should receive the best and most appropriate care and support available. We aim to achieve this by further developing health and social care teams that cohesively work together to provide a model of truly integrated care, which will ensure that support is available to our patients where and when they require it, Only in this way can we hope to meet the challenges facing NNCCG at this time whilst still achieving our prime focus of improving and streamlining outcomes for our patients. 4.3 Our Aims To ensure that the local population experience fully integrated primary and secondary health and social care services For the services delivered to focus upon early intervention and prevention as opposed to purely treatment and crisis management To promote equity and parity of esteem for access to mental health services and care provision To improve and sustain the diagnosis rate for both early onset and advancing Dementia To ensure dignity, compassion and effective symptom control to deliver safe care to people who are at End of Life in their place of choice where possible To support the continued focus upon seldom heard service users in relation to patients who have learning disabilities. To enable the right care in the right place resulting in more people securing the support they require close to home 5. The Framework by which we will Monitor Quality 5.1 This Quality Strategy recognises the CCGs response to the range of quality indicators and guidance based upon National learning and direction such as the Francis Report, Sir Bruce Keogh, Berwick and Cummings report from Winterbourne view and Compassion in practice, all of which place the highest importance on the requirement for safe, quality care for all patients while providing a clear framework 8

9 upon which to establish organisational quality and safety as an implicit part of the Commissioning cycle. In addition we will capture key elements within the NNCCG s Continuous Improvement plan and assess all service change through a system of quality impact thereby placing a range of measures upon our own processes to ensure that we are getting it right for our patients. 5.2 It is important to have a clear and measured framework by which to assure the application of Quality and a systematic and transparent process for ensuring that service development meets the needs of both individual patients and the local community in general, NNCCG will seek to provide: A clear outline of quality indicators with measurable outcomes defined through service specifications and contracts Monitoring of Provider Performance through Clinical Quality forums. Collaboration with Commissioning colleagues from other Norfolk CCG s to aid the development of jointly agreed processes to both monitor and inform quality within Provider contracts (Local quality schedules and Clinical Quality Review Meetings) by undertaking this in partnership; we will aim to strengthen equity of quality standards across the wider Norfolk health economy. Unit/ departmental visits to providers to view and monitor services and performance at the point of care delivery 5.3 The main aim and outcome integral to all core business within NNCCG, is to use and monitor the feedback we receive from our patients and their representatives. To ensure that we are achieving these objectives and to enable us to measure our providers delivery of safe and compassionate care we will ensure that the appropriate mechanisms are in place by: Supporting all providers to implement and monitor the Family and Friends test. Reviewing feedback from patients at GP practice level. Monitoring patients comments recorded on public social media sites Monitoring national surveys such as mental health, cancer and maternity. Reviewing and responding to complaints made directly to the CCG. Screening Quality issue reports and Serious incidents providing constructive feedback to providers and monitoring that required actions are in place. Analysing information relating to providers from external regulators including published reports from Care Quality Commission inspections. Undertaking Quality Assurance Audits within our trusts to support and identify good practice and areas for improvement while monitoring and reviewing patient experience at first hand. Working with providers to identify key themes and trends relating to analysis of their Complaints and Incidents which affect patient experience. Working with Healthwatch as an Independent service user champion for health and Social care to share information and intelligence about the support our patients receive. 9

10 The above assurance process is scrutinised through the function of the Patient Experience Safety and Quality Committee (PESQC). 5.4 In addition NNCCG will learn through its membership the Advancing Quality Alliance (AQuA).and strive to implement its recommendations. This NHS health and care quality improvement organisation is at the forefront of transforming the safety and quality of healthcare. And as such we will learn to further develop models of excellence in-line with the Five Year Forward View, aiming to drive improvement in quality, safety and reliability of our healthcare services. (Please refer to Appendix 1 for the Aqua service transformation model). The culture and values of North Norfolk CCG. 5.5 Safety Thermometer The NHS Safety Thermometer is a national benchmarking tool for measuring, monitoring and analysing patient harms and 'harm free' care. Developed for the NHS by the NHS as a point of care survey instrument, the NHS Safety Thermometer provides a temperature check on harm that can be used alongside other measures of harm to benchmark local and system improvement. The NHS Safety Thermometer includes a function for merging patient safety data across all the teams and wards in an organisation, and a built-in mechanism to submit data to the Health and Social Care Information Centre for inclusion and publication in the national database. This is a useful tool to support comparative outcomes for our providers against similar Trusts and allows questions to be raised around the data and the ability to look to others for possible solutions and areas for improvement. 5.6 Quality Surveillance Group Each Clinical Commissioning Group will manage the relevant quality monitoring mechanism appropriate to the providers for which it is designated as the co-ordinating lead. However the opportunity for informal and formal sharing of information more widely can offer better triangulation of intelligence. To support this process, a high-level regional Quality Surveillance Group meets on a bimonthly basis. With membership from the NHS England, CCG Accountable officers and Directors of quality from Specialist commissioners, Quality managers from Local Councils, Health Education organisations, Regional Healthwatch Chief officers and local senior representatives from regulatory bodies such as CQC and MONITOR. The meeting forms part of the governance structure of each Clinical Commissioning Group and NHS England The purpose of the group is to jointly review quality performance and share information in order to identify potential or actual risks to quality and agree a coordinated response for each provider. 5.7 Commissioning for Quality and Innovation (CQUIN) The Five Year Forward View (FYFV) has set out the vision for promoting well-being and preventing ill health as part of the NHS Contract all providers are required to agree an incentive based scheme of nationally and locally led improvements linked to the monetary value of their contract (usually 2.5% of the overall value will be set aside for this purpose). Norfolk CCG s will ensure that CQUIN incentive schemes are designed to help drive quality changes that are required and linked to the FYFV wherever possible. Key 10

11 focus over the next 2 years will be upon improving the overall patient journey across our Norfolk system, more effective management of discharge processes, developing more aligned systems across secondary and community care services which earlier identify and respond to potential frailty in older individuals and supporting those vulnerable adults within mental health care by developing safer mental health wards and units. Innovation and improvement achieved through subsequent years CQUIN schemes are, wherever practical, embedded into the next year s contract as part of the quality schedule for each provider to ensure continuity and consistency of service improvement moving forward. 5.8 Quality Accounts - Providers of NHS care are required to publish an annual quality account. An outline of key quality initiatives and priorities are detailed for the forthcoming year. Providers are required to outline the clinical audits they have completed locally, regionally and where applicable nationally. The account is within the public domain permitting a greater level of information about the quality of health services available. The Quality Account will enable the providers to demonstrate their commitment to improving outcomes for the local population of NNCCG. This will be in accordance with the key domains in the NHS Outcomes framework. Accounts and will be monitored through the relevant quality forums to ensure they detail an accurate profile of quality improvement against the identified priorities. 6. Quality, Innovation Productivity and Prevention (QIPP) 6.1 The Quality, Innovation, Productivity and Prevention (QIPP) programme is a largescale programme developed by the Department of Health to drive forward required financial savings or reallocation of funds while making quality improvements in NHS care (2012). NNCCG has a significant QIPP programme in place to meet the efficiencies that we are required to make in order to achieve financial balance. The projects are based upon small areas of service change through to total transformation. In order to ensure that Quality remains the prime focus of any service change all QIPP initiatives being undertaken by NNCCG will have a considered quality and equality impact assessment completed in order to highlight the appropriate mitigation of actions required to bring about safe and effective change for our patients. The assessments are presented to, and ratified by the Patient Experience Safety and Quality (PESQ) committee. Which are then reviewed by the QIPP Programme board for executive level sign off in accordance with NNCCG Governance processes. 6.2 In addition, to ensure that patients have a voice within this process we have developed a Community Engagement Panel (CEP) which brings together local patient, advocate and stakeholder representatives to help the CCG to consider the views of our community around the financial recovery plan and QIPP programme. It also acts as a reference group to ensure that the consultation and engagement undertaken by NHS North Norfolk CCG is suitable, proportionate and inclusive. The panel is made up of members from patient groups across North Norfolk and represent a network of service user organisation; they will use their networks to seek 11

12 wider views and make recommendations to the CCG in regards to our QIPP plans. Having input from this panel provides a powerful Patient Voice to guide the CCG towards changes we can safely make and those which are likely to impact most upon our community. CEP review all and challenge proposed QIPP schemes before they are agreed for implementation. 7. Reporting Systems 7.1 Quality Dashboards NNCCG has developed a dashboard outlining quality outcome indicators for local providers. The content aligns to the metrics identified by the National Quality board in synergy with NHS Outcomes framework domains. The purpose being; to ensure that all data is triangulated against a range of information from both local and national sources. This permits for theme and trend analysis to be monitored within provider organisations. Compliance with NHS Constitution targets or failure to achieve these can be scrutinised on a monthly basis. 7.2 NNCCG recognises that safeguarding those who are most vulnerable within our communities is a major aspect in managing quality and safety in our commissioned services. This is therefore a key area and both the Adult and Children s safeguarding policies should inform and cross reference to the effective implementation of this strategy. 8. North Norfolk Clinical Commissioning Group Quality & Safety Structure (internal assurance) (Appendix 2) 8.1 The chair of NNCCG, is ultimately accountable for seeing that Quality and Safety is a maintained within the services commissioned by NNCCG, to support him to undertake this role both the Lay member for quality and patient engagement and indeed the remainder of the Governing body will oversee that they are satisfied with the diligence applied to deliver quality, safety and positive patient experience. However it is the responsibility of everyone within the CCG to work towards ensuring that quality remains our prime focus. 8.2 Therefore Quality and Safety will be represented within every structure of the organisation by; 8.3 The NNCCG Patient Experience, Safety and Quality Committee (PESQ) established in accordance with the organisations Clinical Quality and Patient Safety Strategy, This acts as a sub group of NNCC Group Governing Body and is chaired by the Lay member for quality and patient experience. The Committee will both monitor and document key quality and safety risk issues for NNCCG that will feed into the Quality and Safety reporting systems for: The Council of Members The Governing Body and Risk Register 12

13 Contract Monitoring and operational commissioning group meetings Strategic leads Clinical Commissioning Group cluster Clinical Quality and Patient Safety Committee 8.4 A Patient Safety and Quality function will be represented on behalf of NNCC Group within North East London, Clinical Support Unit represented through a team of experienced clinicians which supports the clear Quality, safety and patient experience requirements within the provider contracts. This function will also be responsible for the collation and monitoring of data in addition to compiling a suite of reports which support the monitoring of quality across all contracts. 8.5 To ensure quality principles are integrated throughout all commissioned services, working with providers that are registered with the Care Quality Commission (CQC) and as part of the contracting process we strive to deliver continuous improvement. The services commissioned by NNCCG include the majority of NHS funded healthcare services. As we commence our role in jointly commissioning Primary care services we also have a responsibility to support quality improvement with our member GP practices. The process to ensure good Corporate and Clinical Governance in meeting contractual statutory duties can be illustrated by referring to the Commissioning cycle Model below. 8.6 The processes utilised by NNCCG to ensure the sustained and effective measurement of quality outcomes in relation to the service improvement cycle can be evidenced by the following forums, meetings and activities that we both lead and initiate Open and effective Contract Quality Review Meetings (CQRM). Continual review and learning from any serious incidents, complaints and never events that occur that enable service improvement. 13

14 Announced/ unannounced clinical provider visits to gain further assurance of the quality of care provision and delivery. Review of workforce development plans and annual training needs analysis. The Development and annual review of Contractual Quality Schedules and safe and responsive service specifications. Analysis of our providers clinical audit outcomes. The development, coordination and monitoring of Commissioning for Quality and Innovation (CQIN) schemes to ensure measurable positive patient outcomes. 9. Quality Strategy Implementation 9.1 This strategy builds upon structures and actions developed in response to the National benchmarks and drivers, and the requirements of the Clinical Commissioning Group structures and governance. NNCCG has developed mechanisms to monitor assurance of the quality of services at a local level; this will be a cycle of continuous improvement supported which will support the ongoing evolvement of this strategy over the next two years. This document cannot be used in isolation, but should be viewed as a dynamic tool to develop alongside NNCCG Continuous Improvement plan, Sign up to Safety pledges and clinical quality and patient safety risk register. The provision of high quality care is inherently complex; Quality is systemic the patient journey cuts across primary and secondary care, health and social care, links with public health services and involves multiple professionals. Therefore, it is a collective endeavour, requiring collective effort and collaboration at every level of the system (National Quality Board, 2012). 14

15 Appendix 1 Integrated Care and Transformational Change Model Advancing Quality Alliance (AQuA)

16 Appendix 2 North Norfolk CCG Quality and Safety Performance Reporting Routes Governing Body Clinical Quality Review Meetings (CQRM) Safeguarding Boards Patient Experience, Safety & Quality Committee (PESQC) Serious Incidents and Never Events Patient Experience and Feedback Action Log Healthwatch Patient Story Complaints 16

17 Appendix 3 NHS Outcomes Framework Patient Safety DOMAIN 5 Treating and caring for people in a safe environment and protecting them from avoidable harm Clinical Effectiveness DOMAIN 1 Preventing people from dying prematurely DOMAIN 2 Enhancing quality of life for people with long term conditions DOMAIN 3 Helping people to recover from episodes of ill-health following injury Patient Experience DOMAIN 4 Ensuring people have a positive experience of care 17

18 Glossary Berwick Report Report into NHS Safety published in February 2013 by Professor Don Berwick, an international expert in patient safety. The report highlights the main problems affecting patient safety in the NHS and makes recommendations to address them. Commissioning for Quality and Innovation (CQUIN) Indicators A payment framework that enables commissioners to reward excellence by linking a proportion of healthcare providers' income to the achievement of locally agreed quality improvement goals. Cummings Strategy A three-year vision and strategy for nursing, midwifery and care staff published by Jane Cummings, Chief Nursing Officer for NHS England in December 2012 that aims to build a culture of compassionate care in all areas of practice Francis Report A report published by Sir Robert Francis QC in February 2013 which examined the causes of the failings in care at Mid Staffordshire NHS Foundation Trust between The report made a total of 290 recommendations on openness, transparency and candour throughout the healthcare system and fundamental standards for healthcare providers. Keogh Report A report published by Professor Sir Bruce Keogh, NHS Medical Director for England, that reviewed the quality of care and treatment provided by fourteen NHS trusts and NHS foundation trusts that were persistent outliers on mortality indicators. His report identified some common challenges facing the wider NHS and set out a number of ambitions for improvement, which seek to tackle some of the underlying causes of poor care. NHS Constitution A document published in 2013 which sets out clearly what patients, the public and staff can expect from the NHS and what the NHS expects from them in return. National Institute for Health and Care Excellence (NICE) A national body that provides independent, authoritative and evidence-based guidance on the most effective ways to prevent diagnose and treat disease and ill health, reducing inequalities and variation. NICE guidance supports healthcare professionals and others to make sure that the care they provide is of the best possible quality and offers the best value for money 18

19 Never Events Never events are serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented. NHS England NHS England is an executive non-departmental public body of the Department of Health. It oversees the budget, planning, delivery and day-to-day operation of the NHS in England as set out in the Health and Social Care Act Outcomes Framework The NHS Outcomes Framework sets out the outcomes and corresponding indicators that are used to hold NHS England to account for improvements in health outcomes, as part of the government s Mandate to NHS England. Patient Reported Outcome Measures (PROMS) Patient Reported Outcome Measures (PROMs) assess the quality of care delivered to NHS patients from the patient perspective. Currently covering four clinical procedures, PROMs calculate the health gains after surgical treatment using pre- and post-operative surveys. The procedures included are hip replacements, knee replacements, groin hernia and varicose veins. Serious Incidents A serious incident is an incident that has occurred during NHS funded healthcare (including in the community), which results in unexpected or avoidable death or severe harm of one or more patients, staff or members of the public. It also includes any scenario that prevents, or threatens to prevent, an organisation s ability to continue to deliver healthcare services, including data loss, property damage or incidents in population programmes like screening and immunisation where harm potentially may extend to a large population Urgent Care Urgent care describes the NHS services that are used when patients need advice or treatment immediately, but which is not an emergency or life-threatening. Urgent care services.s 19