2nd Patient Flow: The Future of Urgent and Emergency Care Congress

In July 2018 the Convenzis Group hosted the 1st Patient Flow: Health and Care Improvement for Urgent and Emergency Care Congress, due to the success and popularity of the event we will be hosting the 2nd event in London on the 27th of February 2019.

“A briefing from Nuffield Trust warns that the NHS can no longer find enough bed space to move patients through hospitals quickly and meet key A&E targets and that its practice of counting patients at midnight means that the true scale of the squeeze is being missed.”

Across the NHS, staff work around the clock to deliver the best possible care to more patients than ever before, but it’s becoming increasingly difficult as demand continues to rise.

The current system is under increasing pressure, NHS England wants to improve the urgent and emergency care (UEC) system, so patients get the right care in the right place, whenever they need it.

Technology is changing and so is the way people access services and that’s why we are piloting NHS 111 online which will mean people can access urgent care services over the internet.

In the future, health records will also be available to clinicians however a patient accesses the health service, whether this is through NHS 111, by ambulance, their GP or A&E.

NHS England has set in place a series of pilots and programmes that will help to manage the current demand that the Urgent and emergency care services face, our conference will give you first-hand insight into these impending changes.

Key topics will include:

• Paramedic prescribing
• Ambulance Response Programme
• From hospital to home programme
• Urgent and emergency care vanguards
• Urgent and emergency care channel shift model
• NHS 111 online

Places are currently minimal for this event, so please get in touch today to register your place and avoid missing out on what is shaping up to be another engaging and insightful day.

We look forward to meeting you on the day.

*Research sources: NHS England

Patient Flow: Health and Care Improvement for Urgent and Emergency Care Congress

urgent care event

In July 2018 we will be working in partnership with NHS England, NHS Digital and NHS clinical leaders network to bring you a 1 day conference that will focus on Patient flow and the current methods being implemented to help reduce the demand on urgent care departments across the UK.

Each year the NHS provides around 110 million urgent same-day patient contacts. Around 85 million of these are urgent GP appointments, and the rest are A&E or minor injuries-type visits. Some estimates suggest that between 1.5 and 3 million people who come to A&E each year could have their needs addressed in other parts of the urgent care system. They turn to A&E because it seems like the best or only option. The rising pressures on A&E services also stem from continued growth in levels of emergency admissions and from delayed transfers of care when patients are fit to leave hospital. Working with NHS England we are opening open up valued discussions between peers and demonstrating the great work that is already being done across the UK

What’s been achieved in England over the past three years?

  • Cared for 23 million A&E attendances in 2016/17, 1.2 million more than three years ago.
  • Boosted the capacity and capability of NHS 111, which now takes 15 million calls each year, up from 7.5 million three years ago.
  • Expanded “Hear and Treat” and “See and Treat” ambulance services so that they now cover 3.5 million people, with the provision of telephone advice and treatment of people in their homes saving needless trips to hospital.
  • Developed an integrated urgent care model, offering a single point of entry for urgent care via NHS 111, and rolled it out to 20% of the population.
  • Increased NHS staff uptake of winter flu vaccinations from 49% last year to 63% this year – the highest ever.

Our Urgent and Emergency Care conference for 2018 will be looking into improvements across the UK for access to immediate and urgent care. We are already working with NHS England, NHS Digital, British Medical Association and Health Education to name a few. This is a great opportunity for you and your organisation to hear from both public and private sector on how to adopt change

The event will give delegates the opportunity to listen, learn and engage with some of the UK’s most reputable speakers, it will also provide 4 hours of networking time and 8 CPD points for all attendees.

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Urgent and emergency care

Each year the NHS provides around 110 million urgent same-day patient contacts. Around 85 million of these are urgent GP appointments, and the rest are A&E or minor injuries-type visits. Some estimates suggest that between 1.5 and 3 million people who come to A&E each year could have their needs addressed in other parts of the urgent care system. They turn to A&E because it seems like the best or only option. The rising pressures on A&E services also stem from continued growth in levels of emergency admissions and from delayed transfers of care when patients are fit to leave hospital.

Frontline staff have pulled out all the stops, but over this past winter there have been real difficulties. In providing nine out of ten patients with A&E care within four hours over the past year, the UK offers our patients the fastest national A&E treatment of any major industrialised country. However, in recent years the proportion of patients looked after within 4 hours has been falling – caused by rising demand in A&E departments, with the fragmented nature of out-of-hospital services unable to offer patients adequate alternatives; the need to adopt good practice in hospitals consistently; and difficulties in discharging inpatients when they are ready to go home. So we need to take action to improve services for patients and reduce pressure on our staff.

What’s been achieved in England over the past three years?

  • Cared for 23 million A&E attendances in 2016/17, 1.2 million more than three years ago.
  • Boosted the capacity and capability of NHS 111, which now takes 15 million calls each year, up from 7.5 million three years ago.
  • Expanded “Hear and Treat” and “See and Treat” ambulance services so that they now cover 3.5 million people, with the provision of telephone advice and treatment of people in their homes saving needless trips to hospital.
  • Developed an integrated urgent care model, offering a single point of entry for urgent care via NHS 111, and rolled it out to 20% of the population.
  • Increased NHS staff uptake of winter flu vaccinations from 49% last year to 63% this year – the highest ever.

Key deliverables for 2017/18 and 2018/19

Trusts and CCGs will be required to meet the Government’s 2017/18 mandate to the NHS that: 1) in or before September 2017 over 90% of emergency patients are treated, admitted or transferred within 4 hours – up from 85% currently; 2) the majority of trusts meet the 95% standard in March 2018; and 3) the NHS overall returns to the 95% standard within the course of 2018. In order to do so:

  • Every hospital must have comprehensive front-door clinical streaming by October 2017, so that A&E departments are free to care for the sickest patients, including older people.
  • By October 2017 every hospital and its local health and social care partners must have adopted good practice to enable appropriate patient flow, including better and more timely hand-offs between their A&E clinicians and acute physicians, ‘discharge to assess’, ‘trusted assessor’ arrangements, streamlined continuing healthcare processes, and seven day discharge capabilities.
  • Hospitals, primary and community care and local councils should also work together to ensure people are not stuck in hospital while waiting for delayed community health and social care. They need to:
    • ensure that the extra £1 billion provided by the Chancellor for investment in adult social care in the March budget is used in part to reduce delayed transfers of care, thereby helping to free up 2000-3000 acute hospital beds – the equivalent of opening 5 new hospitals – and regularly publish the progress being made in this regard (22).
    • ensure that 85% of all assessments for continuing health care funding take place out of hospital in the community setting, by March 2018.
    • Implement the High Impact Change Model (23) for reducing DTOCs, developed by the Local Government Association, the Association of Directors of Adult Social Care Services, NHS Improvement and NHS England.
  • Specialist mental health care in A&Es: 74 24-hour ‘core 24’ mental health teams, covering five times more A&Es by March 2019, than now. The service will be available in more than a quarter of acute hospitals by March 2018 and reach nearly half by March 2019, compared with under one-in-ten today.
  • Enhance NHS 111 by increasing from 22% to 30%+ the proportion of 111 calls receiving clinical assessment by March 2018, so that only patients who genuinely need to attend A&E or use the ambulance service are advised to do this. GP out of hours and 111 services will increasingly be combined. By 2019, NHS 111 will be able to book people into urgent face to face appointments where this is needed.
  • NHS 111 online will start during 2017, allowing people to enter specific symptoms and receive tailored advice on management.
  • Roll out evening and weekend GP appointments, to 50% of the public by March 2018 and 100% by March 2019.
  • Strengthen support to care homes to ensure they have direct access to clinical advice, including appropriate on-site assessment.
  • Roll-out of standardised new ‘Urgent Treatment Centres’ which will open 12 hours a day, seven days a week, integrated with local urgent care services. They offer patients who do not need hospital accident and emergency care, treatment by clinicians with access to diagnostic facilities that will usually include an X-ray machine. We anticipate around 150 designated UTCs, offering appointments that are bookable through 111 as well as GP referral, will be treating patients by Spring 2018.
  • Working closely with the Association of Ambulance Chief Executives and the College of Paramedics, implement the recommendations of the Ambulance Response Programme by October 2017, putting an end to long waits not covered by response targets. Actions taken will be subject to the results of evaluation and approval from Ministers.

How changes will be implemented

  • £100 million in capital funding will be provided to support modifications to A&Es to enable clinical streaming by October 2017.
  • Clearer local performance incentives. Previous standard contract fines have been dropped. From April 2017 the rules governing the performance element of the £1.8 billion Sustainability and Transformation Fund (STF) for acute trusts that relates to A&E will be amended in agreement with Department of Health and HM Treasury (24).
  • Aligned national programme management. To ensure complete alignment between NHS England and NHS Improvement in supporting and overseeing urgent implementation of the above actions, we have appointed a single national leader accountable to both NHS England and NHS Improvement. We will also bring together the work of NHS Improvement’s and NHS England’s national urgent and emergency care teams. From 1stApril 2017 a single, named Regional Director drawn from either NHS Improvement or NHS England will hold to account both CCGs and trusts in each STP area for the delivery of the local urgent care plan. Each RD will therefore act with the delegated authority of both NHS Improvement and NHS England in respect of urgent and emergency care.
  • Broader improvement support. Building on the work of the Emergency Care Improvement Programme and the regional teams of NHS England and NHS Improvement, we will offer a broader range of improvement support to frontline staff to achieve the priorities set out above. This will include extending to emergency care both the Getting it Right First Time Programme and the Model Hospital, together with joint work with the Royal College of Emergency Medicine and other professional bodies on workforce and a more standardised clinical operating model.
  • Detail on the technology changes to support these approaches is included in Chapter Nine.
  • The NHS 111 workforce is being developed to deliver these changes and to provide them with the career structure and support they need to thrive.

Urgent Care

Article source: NHS England

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Urgent treatment centres

Urgent treatment centres will be GP-led, open at least 12 hours a day, every day, and be equipped to diagnose and deal with many of the most common ailments people attend A&E for.

Urgent treatment centres will ease the pressure on hospitals, leaving other parts of the system free to treat the most serious cases. The urgent treatment centre offer will result in decreased attendance at A&E, or, in co-located services, the opportunity for streaming at the front door. All urgent treatment centre services will be considered Type 3 / 4 A&E and will contribute to the 4 hour access and waiting times target locally.

Why change?

The patient always comes first, and as outlined in ‘Next Steps’ the NHS’ aim over the next two years is to provide patients with the most appropriate care in the right place, at the right time.

The reasons for this are simple. We all know where to go when life is in danger – A&E. But estimates suggest up to 3 million people who come to A&E each year could have their needs addressed elsewhere in the urgent care system, but patients tell us that the range of alternatives available can be confusing – Walk In Centres, Urgent Care Centres, Minor Injury Units and others with local names and all with differing levels of service. So A&E is understandably the default choice for many people unsure where to turn when they need urgent care or advice.

This is bad for the NHS because it puts unnecessary pressure on A&E and other parts of the urgent and emergency care system, and it’s bad for patients because many are treated in the wrong setting.

So we are introducing new urgent treatment centres, which will standardise this confusing range of options and simplify the system so patients know where to go and have clarity of which services are on offer where.

What’s happening?

The NHS will roll out around 150 urgent treatment centres by December this year and by December 2019 all services designated as urgent treatment centres will meet the guidelines we have now issued.

We have now published the guidance local areas need to get started on setting up new urgent treatment centres. The next step is for Commissioners, supported by NHS England regions, to review current provision against guidelines and make a plan for each facility. Where locally appropriate plans will be subject to consultation so the views of patients and the public will be heard.

View some of the frequently asked questions to support implementation.

Original source: Click here