Urgent CareNorth Somerset Clinical Commissioning Network

Introductions

• Dr. Kevin Heggarty – Chair, North Somerset Urgent Care Clinical Network

• Mark Hemmings – Urgent Care Programme Manager, SW Commissioning Support

Our SessionsSession 1:Urgent Care animationChallenges and plans!Q&A: listening to your experiences

10 minute break

Session 2:Group workExploring case studies to identify what could add value to the patient experience. The outcomes of this session will help to inform future priorities and planning.

Session 1

Setting the scene…….“Urgent Care” – a helpful animation produced by The Kings Fund

Transforming Urgent Care:• Resources • Demand• Complexity

Real net spending on UK NHS

Zero growth until 2017

2017

Rising Demand

• Demographic change • Medical advances• Patient expectation• Failure demand• Lifestyle

Care mountain

High risk

Cost

Low risk Demand

Secondary careRH/NH

Primary andCommunity Care

Patients and public

PatientSystem

Funding

http://www.awp.nhs.uk/

Weston (North Somerset) Urgent Care Working Group

Primary Care, Voluntary Action NS, Lay member, Somerset CCG

= 14 organisations represented

Design principles:

1. Consistent2. Simple3. Right first time4. Efficient and effective

ED front door streaming. Building a community infrastructure. ABC raising awareness campaign Geriatrician team Care Home Support 7 day working Enhanced ambulatory care

Creating a constantly improving system

•Clinical engagement•Alamac dashboard•Building relationships•Incident reporting•Clinical audits•Patient experiences

Q&A: Your experiences of urgent care

Questions?

Experiences?

During this session we will try to capture the main points of your experiences and, if possible, use in Session 2 to explore further

Session 2

• Format - 2 facilitated groups exploring different case studies

• Ground rules• Key questions:– What went well?– What went wrong?– What could have been done differently?We should be continually striving to add value for the patient and eliminate waste

What next?

• We will capture “What you said…..” and put together all your comments, suggestions and ideas. These will be included in the event feedback.

• Your comments will also be really useful to help shape future priorities and plans

Thank you!10 minute break then regroup in Red Room

Case study 1

• Working age man• Lives with family• Develops cough, has discomfort and generally doesn’t feel

great• Wants GP appointment but can’t afford to take a half day off

work• Struggles through week• On Saturday calls the Out Of Hours doctor• Told to go to a primary care centre• Diagnosed with a chest infection• Needs tests – admitted to hospital

Case Study 2

• Mum of young children• No extended family locally• Toddler 18 months consistently at GPs with “fevers”• Beginning of Tuesday, toddler is again unwell by

evening hot and crying constantly• Calls ambulance• Paramedic attends• Toddler taken to Bristol Children’s Hospital for

assessment• Siblings cared for by neighbour

Case Study 3

• 36 year old female• History of alcohol and drug misuse• Recently come out of rehab centre• Relapses - starts drinking again• Using benzodiazipines• Goes to GP who prescribes Diazepam• Regularly going to ED in agitated state sometimes

intoxicated sometimes in withdrawal from alcohol

Case Study 4

• 86 year old man living alone• History of • Seen GP• Booked to haver injection fiollowing week• Pain continues and makes immobile• Phones 999 for ambulance• Taken to hospital• Seen by ED team but relatively junior doctor• Suspected DVT – admitted to hospital• Stays in several days• Discharged with pain relief but less mobile