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Commissioning and the ED

Commissioning and the ED. Dominic Williamson EM Consultant RUH Bath. Background. DGH 70,000 patients per year ‘High acuity’ High occupancy Long trolley waits Poorly performing. ED problem Trust problem Health community problem Urgent Care Network. UCN.

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Commissioning and the ED

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  1. Commissioning and the ED Dominic Williamson EM Consultant RUH Bath

  2. Background • DGH 70,000 patients per year • ‘High acuity’ • High occupancy • Long trolley waits • Poorly performing

  3. ED problem • Trust problem • Health community problem • Urgent Care Network

  4. UCN • Face to face contact with providers and commissioners • Chaired by PCT • What we’ve done…. …. what can we do • Pilots galore

  5. IST • Improved discharges/access to care • Improved response in escalation • More co-ordinated community response • Collocation of GP OOHs • Nursing home LES • Front door streaming

  6. Stagnation • Treading water past 18 months • No new projects • Recoiling from integration • Increasing isolation • Getting to know you

  7. New dawn CCG • Effective change or ‘shall we just carry on for now’ • Local GPs • Easy access • Making the right noises

  8. Urgent care THE priority • Chairing the UCN • Changes with quality, performance and finance in mind • Do appear to listen.

  9. Support • Co-location of walk in service • Co-ordination of MIU services • Move to assessment service • Unified GP response • Improved EoL planning and care • Improved information sharing

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