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NDUC – North

Scotswood

Eston Grange

Vocare North East Locations

NDUC - Tees

North East Operations Centres

Northern Doctors Urgent Care

North East Ambulance Service

North East NHS 111 Service

North East NHS 111

1996 800 2.3 million £23 million

Vocare Group Facts

Northern Doctors Urgent Care

GP Led

7 GPs in Senior ClinicalManagement Team

24/7 Clinical on Call

Integrated Group Clinical Review

Tees March 2013 NQR Performance

NQR1 Service Monitoring and Data Reporting Number of working days following end of relevant month for service to produce report 100%

NQR2 Communication Percentage of details of OOH patient consultations (including clinical information) transmitted to the GP practice where the patient is registered by 08:00hrs the next working day.

100%

NQR8a Initial telephone call Percentage of calls engaged (no more than 0.1%) 100%NQR8b Initial telephone call Percentage of calls abandoned 98%NQR8c Initial telephone call Percentage of calls answered within 60 seconds of the end of the introductory message (maximum 30

seconds for introductory message)96%

NQR9a Telephone clinical assessment Percentage of patients suffering from immediate and life threatening conditions whose calls are passed to the ambulance service within 3 minutes of their condition being identified.

100%

NQR9b Definitive clinical assessment -telephone Percentage of urgent calls where definitive clinical assessment is started within 20 minutes of the call being answered by a person

100%

NQR9c Definitive clinical assessment -telephone Percentage of all other calls where definitive clinical assessment is started within 60 minutes of the call being answered by a person

96%

NQR10a Face to face clinical assessmnet Percentage of patients suffering from immediate and life threatening conditions whose are passed to the ambulance service within 3 minutes of their condition being identified.

100%

NQR10b Definitive clinical assessment -face to face Percentage of patients with urgent needs where definitive clinical assessment is started within 20 minutes of the patient arriving at the centre.

100%

NQR10c Definitive clinical assessment -face to face Percentage of all other patients where definitive clinical assessment is started within 60 minutes of the patient arriving at the centre.

100%

NQR12a Face to face consultations (either in a centre or in the patient's place of residence)

Percentage of patients whose face to face consultation (following definitive clinical assessment) takes place within 1 hour (where classed as an emergency)

100%

NQR12b Face to face consultations (either in a centre or in the patient's place of residence)

Percentage of patients whose face to face consultation (following definitive clinical assessment) takes place within 2 hours (where classed as urgent)

97%

NQR12c Face to face consultations (either in a centre or in the patient's place of residence)

Percentage of patients whose face to face consultation (following definitive clinical assessment) takes place within 6 hours (where classed as less urgent)

99%

NQR13 Access to interpretation services Percentage of patients who are unable to communicate effectively in English provided with an interpretation service within 15 minutes of initial contact.

100%

Audit

NHS Tees A&E Audit carried out by Dr Peter Haywood NHS Tees

Period 10 June 2013 to 17 June 2013

NDUC A&E/999 Audit carried out by Dr Edward Summers NDUC

Outcomes – A&E

2857 Total A&E Attendances

25 NDUC A&E/999 referrals to A&E

922 NDUC Cases

0.88% of A&E Attendances

2.71% of NDUC Cases

NDUC

Non NDUC

Outcomes – Admissions (not A&E)

7.5% of NDUC cases this week

5.4% of NDUC cases July 2013

Total Secondary Referrals (Admissions + A&E/999)

National 12-16%

(Primary Care Foundation Report of April 2012)

NDUC 10%

(NDUC Internal)

999 Cases

• complicated distressed acute retention of urine following cystoscopy that day

• lab result indicating a heart attack

• cardiac chest pain with history of previous heart attack

• ?stroke

• cardiac chest pain and difficulty in breathing • significant overdose of painkillers

A+E Cases

• 3 arranged after face to face assessments – 92yo fall, 93yo fall, 11yo wrist injury after discussion with A&E Consultant

• 3 sent to A&E after discussion with district nurses

regarding patients with catheter problems

• 2 patients elected to attend A&E despite offer of centre appointment

• 1 patient sent to A&E after discussion with Gynaecology on call

A+E Cases

• 1 patient called ambulance prior to NDUC Dr telephone assessment

• 1 patient assessed at 2300hrs with eye symptoms – referred to Eye Casualty Clinic the next morning

• 6yo with needle stick injury from syringe on allotment

• 32yo with malaena (significant stomach bleeding)

• Severe abdominal pain with pain score 10/10

A+E Cases

• abdominal pain

• incarcerated hernia • 12m baby vomiting x40 over 34hrs

• Suspect ectopic pregnancy/miscarriage

• Unwell infant

• ?Croup

Total Secondary Referrals (Admissions + A&E/999)

National 12-16%

(Primary Care Foundation Report of April 2012)

NDUC 10%

(NDUC Internal)

2012/13

2012/13

Moving Forward

• Paramedic Support

• Special Patient Notes

• Access to GP Patient Records

• CREAM (Clinical Review Evaluation and Assessment Meetings)

• SERRG (SEcondary Referral Review Group)