unscheduled care in cardiff &vale taking a whole systems approach to emergency & urgent care
TRANSCRIPT
Unscheduled Care In Cardiff &Vale
Taking A Whole Systems Approach to Emergency & Urgent Care.
Context Drivers for Change
National Policy
Local Framework for Delivery
A New Integrated Service Model
Policy Landscape
Designed for Life 2005
Regional Clinical Service Strategy
Reforming Emergency Care DH 2001
Taking Healthcare to the Patient DH 2005
National Audit Office Report 2006
WAG Developing Emergency Care Services (DECS) 2005
Unscheduled Care Framework
Access Assessment Intervention
Access – how does a patient with a need for urgent care access those services both remotely (e.g. by phone) or walk up (e.g. by A&E) and what sort of responses should they get ?
Assessment – once the patient is in contact with the urgent care services, how should there needs be most appropriately assessed ?
Intervention – once the patients needs have been assessed, interventions should match their needs i.e. appropriate care in an appropriate location.
Current Model (Access) Highly Efficient ! Multiple access / entry points (remote & walk up) Limited case completion / referral Uncoordinated Audit Fragmented & risk intensive Expensive
Current Model (Assessment) Multiple Assessment Criteria
Uncoordinated – critical information not shared between providers (Lamming 2003)
Limited IM&T and management linkage between providers
Limited continuity of information for clinicians in every sector
Current Model (Intervention) Limited use of pre - hospital alternatives & direct
referral to community based services
AMPDS - No Category C pathways
Limited use of ECP, ENP & allied professionals
A&E is the default
Improvements Sought… A model that maximises the strengths of existing
providers and infrastructure Earlier case completion in the unscheduled care
pathway (remote & walk up) Care delivered closer to home Improved signposting (remote & walk up) Safe & clinically driven Better integration of providers (in & out of hours) Common assessment Value for Money Single point of access ??
New Model (Vision) Patient & pathway focussed Strong clinical leadership at every level Enhanced use of pre- hospital alternatives, cat c,
community based services, ECPs & UCCs Integrated & educational (multidisciplinary team
approach) R&D platform Clear access criteria and working protocols between
providers Appropriate Intervention Reduced dependency on hospital admission Cost effective & cost saving
Outcomes Managed demand Improved Access, Assessment and Intervention Better case completion at first contact Maximised use of existing providers and infrastructure
(IM&T / Estate / People) Better integration between providers & professionals -
NAO 2006
Improved workforce & educational development Improved performance (in all sectors)
Key Priorities Clinical engagement and leadership in the new service model
Education & training priorities for skillspool
Governance and accountability framework
Assessment Process
IM&T
Information sharing
Pathway development
Conclusion / Next Steps Consultation with wider health community
Agree strategic direction
Integrated into PHSI
Detailed commissioning and transition plan
Implementation overseen by PHSI & UCB
Thank YouMark Ellis, NHS Regional Emergency Care Lead