Delivering an Integrated Urgent Care Service 23 rd March 2016
A confusing (and piecemeal?) service
Awareness of 3DNs very different services 3DNs 3
Associations with other 3DNs very different services 3DNs vital public service with number to match useful private-sector service with a less special number 4 where does 3DN service sit 4
A new front door to urgent care services
NHS 111 in the news 6
NHS 111 the good news Over 1 million calls a month/ now 14 million calls per annum for the first time. 90% of users say they are satisfied with the service. 27% of callers would have gone to A&E 8% of callers actually went to A&E after calling NHS 111 9 out of 10 midweek calls answered within 60 seconds 7
The vision for a functionally integrated 24/7 Urgent Care Service: Four key components of service - 1. Access 2. Assessment 3. Advice 4.Treatment
Integrated Urgent Care Model Following the relative success of NHS 111, and to deliver the objectives of the Urgent and Emergency Care Review, the aim is to pull together the separate working arrangements between current NHS 111 providers and GP Out-of-Hours (OOH) services and more closely align both with community, emergency departments and ambulance services. This will enable commissioners to deliver 24/7 access to urgent clinical assessment, advice and treatment. Before After 9
The new strong offer to the public: NHS Urgent Care starts to look like what the patients tell us they want, not what we have historically offered. A single number NHS 111 for all your urgent health needs Be able to speak to a clinician if needed That in the future your health records are always available to clinicians treating you wherever you are (111, 999, community, hospital) To be booked into right service for you when convenient to you You will receive a clinically appropriate response to 999 which may mean you receive treatment advice by phone, in person by ambulance staff or taken to hospital Care close to home (at home) unless need a specialist service Access to specialist care services (e.g. major trauma/stroke) will be through a network that includes specialist hospitals in your wider area 10
The 8 Key Elements of IUC Integration Level 2016/17 Proposed Threshold 2020 Proposed Threshold 1. A single call to get an appointment Out of Hours 70% 95% 2. Appointments can be made to in-hours GPs 5%* 50%* 3. Data can be sent between providers 50% 80% 4. The Summary Care Record (SCR) is available in the hub and elsewhere 100% 100% 5. Care plans and patient notes are shared 50% 90% 6. There is a Clinical Hub containing GPs and other health care professionals, 24 hours, 7 days a week; transferring more than 30% of all calls answered to a healthcare professional in the hub. 7. The capacity for NHS111 and OOHs is jointly planned 30% 50% 100% 100% 8. There is joint governance across Urgent and Emergency Care providers 100% 100% *NB These targets are relatively low as higher thresholds would require contractual change 11
NHS 111 Integrated Urgent Care Workforce Development Programme Joint Programme of work between NHS England and Health Education England Set up in April 2015 and it is planned to run for 3 years Overarching aim is to support the development of the optimal NHS 111 / Integrated Urgent Care call centre workforce for the future 12
What are we doing? The Programme is working with Effective Workforce Solutions, Health Education England and two NHS 111 provider sites to develop a competency framework To examine the current, and scope out the optimal, workforce; Competences skills & behaviours Composition skills mix & sharing within the workforce Career structure the scope for development & opportunity to progress Work will identify the functions and tasks staff currently perform and the additional skills / roles needed now and for the future to deliver an optimal workforce. This will run from January to October 2016
Why are we doing it? To improve services and patient outcomes, aiming to: Decrease Ambulance and ED dispositions Increase Hear & Treat - so patient s receive the right help first time Increase the clinical competence of NHS 111 Manage staff attrition and high turnover
Where are we now? Published Commissioning Standards October 2015 Working with Transformation Areas (TAs), U&EC Vanguards & self selectors as early adopters of IUC Service Need whole system planning and implementation in particular with GPs, wider primary care providers, community services providers and crucially with EDs (in particular in TAs) Phone before you go.. NHS 111 the Smart Call to make.. Talk before you Walk hopefully not!! Stop the use of local geographic numbers for OOH providers
Did I mention that 111 is just a telephone number? It s not a provider and never will be! 16
From P to O via LA