parallel session 3.3 unscheduled care unpacked
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UNSCHEDULED CARE UNPACKED
Definition of Unscheduled Care
‘Unscheduled care’ is defined as NHS care which cannot reasonably be foreseen or planned in advance of contact with the relevant healthcare professional, or is care which, unavoidably, is outwith the core working period of NHS Scotland. It follows that such demand can occur at any time and that services to meet this demand must be available 24 hours a day
Kerr Report (2005)
Recommended shift from
Assess-Transport-Diagnose-Treat
to
Assess-Diagnose-Talk-Treat
Patient
NHS2422,450 GP
Out ofHours16,050
EmergencyAmbulance
11,000MIU2,750
A&E27,100
Admitted(EmergencyInpatient)10,400
Treatedat Scene/
NotConveyed
3,450
HealthcareProfessional
Scotland Unscheduled Care Patient Flow Chart 2008/ 09Rates per 100,000 Population
1,750
1,150
550
400
1,050 250
1,950
2,000
150
12,650
6,850
100
6,700
1,5002,950
1,050
7,350200
50
16,400
PAA/ ARAU/MAU3,100
1,400
1,100
1,350
50
300
200
150
2,200
450
50
150
50
150
Total Attendances at A&E Services by Site Type - Scotland (April 2011 to March 2012)
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12
Num
ber
of
Att
endance
s
ED MIU/Other
Attendances by Site Type
Source: A&E Data Mart, ISD Scotland
Number of Attendances at A&E Services across Scotland and Proportion of those seen within 4 hours (January 2009 to March 2012)
80,000
100,000
120,000
140,000
160,000
Jan
-09
Fe
b-0
9
Ma
r-0
9
Ap
r-0
9
Ma
y-0
9
Jun
-09
Jul-0
9
Au
g-0
9
Se
p-0
9
Oct
-09
No
v-0
9
De
c-0
9
Jan
-10
Fe
b-1
0
Ma
r-1
0
Ap
r-1
0
Ma
y-1
0
Jun
-10
Jul-1
0
Au
g-1
0
Se
p-1
0
Oct
-10
No
v-1
0
De
c-1
0
Jan
-11
Fe
b-1
1
Ma
r-1
1
Ap
r-1
1
Ma
y-1
1
Jun
-11
Jul-1
1
Au
g-1
1
Se
p-1
1
Oct
-11
No
v-1
1
De
c-1
1
Jan
-12
Fe
b-1
2
Ma
r-1
2
Nu
mb
er
of
Att
en
da
nc
es
90
92
94
96
98
100
Se
en
wit
hin
4 h
ou
rs (
%)
Number of Attendances Seen within 4hr 4hr Wait Standard
4 Hour Wait Standard
Source: A&E Data Mart, ISD Scotland
Major/Minor Activity
Data Source: A&E Data Mart, ISD Scotland
Major/Minor Activity - Scotland
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Sep-0
9
Oct-09
Nov-0
9
Dec-0
9
Jan-
10
Feb-1
0
Mar
-10
Apr-1
0
May
-10
Jun-
10
Jul-1
0
Aug-1
0
Sep-1
0
Oct-10
Nov-1
0
Dec-1
0
Jan-
11
Feb-1
1
Mar
-11
Apr-1
1
May
-11
Jun-
11
Jul-1
1
Aug-1
1
Sep-1
1
Oct-11
Nov-1
1
Dec-1
1
Jan-
12
Ra
te p
er
10
0,0
00
Po
pu
lati
on
Major Rate Minor Rate
Major/Minor Activity by Age Band
Data Source: A&E Data Mart, ISD Scotland
Major/Minor Activity - 0-4 year olds in Scotland
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Sep-0
9
Oct-09
Nov-0
9
Dec-0
9
Jan-
10
Feb-1
0
Mar
-10
Apr-1
0
May
-10
Jun-
10
Jul-1
0
Aug-1
0
Sep-1
0
Oct-10
Nov-1
0
Dec-1
0
Jan-
11
Feb-1
1
Mar
-11
Apr-1
1
May
-11
Jun-
11
Jul-1
1
Aug-1
1
Sep-1
1
Oct-11
Nov-1
1
Dec-1
1
Jan-
12
Ra
te p
er
10
0,0
00
Po
pu
lati
on
Major Rate Minor Rate
Major/Minor Activity by Age Band
Data Source: A&E Data Mart, ISD Scotland
Major/Minor Activity - 5-9 year olds in Scotland
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Sep-0
9
Oct-09
Nov-0
9
Dec-0
9
Jan-
10
Feb-1
0
Mar
-10
Apr-1
0
May
-10
Jun-
10
Jul-1
0
Aug-1
0
Sep-1
0
Oct-10
Nov-1
0
Dec-1
0
Jan-
11
Feb-1
1
Mar
-11
Apr-1
1
May
-11
Jun-
11
Jul-1
1
Aug-1
1
Sep-1
1
Oct-11
Nov-1
1
Dec-1
1
Jan-
12
Ra
te p
er
10
0,0
00
Po
pu
lati
on
Major Rate Minor Rate
Major/Minor Activity by Age Band
Data Source: A&E Data Mart, ISD Scotland
Major/Minor Activity - 20-24 year olds in Scotland
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Sep-0
9
Oct-09
Nov-0
9
Dec-0
9
Jan-
10
Feb-1
0
Mar
-10
Apr-1
0
May
-10
Jun-
10
Jul-1
0
Aug-1
0
Sep-1
0
Oct-10
Nov-1
0
Dec-1
0
Jan-
11
Feb-1
1
Mar
-11
Apr-1
1
May
-11
Jun-
11
Jul-1
1
Aug-1
1
Sep-1
1
Oct-11
Nov-1
1
Dec-1
1
Jan-
12
Ra
te p
er
10
0,0
00
Po
pu
lati
on
Major Rate Minor Rate
Major/Minor Activity by Age Band
Data Source: A&E Data Mart, ISD Scotland
Major/Minor Activity - 50-54 year olds in Scotland
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Sep-0
9
Oct-09
Nov-0
9
Dec-0
9
Jan-
10
Feb-1
0
Mar
-10
Apr-1
0
May
-10
Jun-
10
Jul-1
0
Aug-1
0
Sep-1
0
Oct-10
Nov-1
0
Dec-1
0
Jan-
11
Feb-1
1
Mar
-11
Apr-1
1
May
-11
Jun-
11
Jul-1
1
Aug-1
1
Sep-1
1
Oct-11
Nov-1
1
Dec-1
1
Jan-
12
Ra
te p
er
10
0,0
00
Po
pu
lati
on
Major Rate Minor Rate
Major/Minor Activity by Age Band
Data Source: A&E Data Mart, ISD Scotland
Major/Minor Activity - 70-74 year olds in Scotland
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Sep-0
9
Oct-09
Nov-0
9
Dec-0
9
Jan-
10
Feb-1
0
Mar
-10
Apr-1
0
May
-10
Jun-
10
Jul-1
0
Aug-1
0
Sep-1
0
Oct-10
Nov-1
0
Dec-1
0
Jan-
11
Feb-1
1
Mar
-11
Apr-1
1
May
-11
Jun-
11
Jul-1
1
Aug-1
1
Sep-1
1
Oct-11
Nov-1
1
Dec-1
1
Jan-
12
Ra
te p
er
10
0,0
00
Po
pu
lati
on
Major Rate Minor Rate
Major/Minor Activity by Age Band
Data Source: A&E Data Mart, ISD Scotland
Major/Minor Activity - 85 year olds and over in Scotland
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Sep-0
9
Oct-09
Nov-0
9
Dec-0
9
Jan-
10
Feb-1
0
Mar
-10
Apr-1
0
May
-10
Jun-
10
Jul-1
0
Aug-1
0
Sep-1
0
Oct-10
Nov-1
0
Dec-1
0
Jan-
11
Feb-1
1
Mar
-11
Apr-1
1
May
-11
Jun-
11
Jul-1
1
Aug-1
1
Sep-1
1
Oct-11
Nov-1
1
Dec-1
1
Jan-
12
Ra
te p
er
10
0,0
00
Po
pu
lati
on
Major Rate Minor Rate
Proportion of Patients Admitted Following a New and Unplanned Return Attendance at EDs across Scotland by Age Band and Gender (April 2011 to March 2012)
-
10.0
20.0
30.0
40.0
50.0
60.0
70.0
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ AllAges
Pro
po
rtio
n A
dm
itte
d (
%)
Male Female
Source: A&E Data Mart, ISD Scotland
Emergency Admissions