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Urgent Care Planning in South Tyneside

Urgent Care Planning in South Tyneside. David Hambleton . Urgent Care Everyone’s problem. Urgent Care Plans. Urgent Care – Everyone’s problem so nobody’s problem Why is it a problem High A&E attendances but Low admission rates Lots of people in A&E who needn’t be.

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Urgent Care Planning in South Tyneside

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  1. Urgent Care Planning in South Tyneside David Hambleton Urgent Care Everyone’s problem

  2. Urgent Care Plans • Urgent Care – • Everyone’s problem so nobody’s problem • Why is it a problem • High A&E attendances but • Low admission rates • Lots of people in A&E who needn’t be

  3. Percentage of A&E Attendances converting to Admissions

  4. Over-crowding in A&E Why it’s a very bad thing • After admission through a crowded A&E 43% increased chance of dying at 10 days • A&E stay of 4-8 hours increases inpatient length of stay by 1.3 days • A&E stay >12 hours increases inpatient length of stay by 2.35 days

  5. What can be done prior to A&E • GP Access • Quality Premium (GP QOF) • Ambulatory Care Conditions • A&E usage • Anticipating urgent care demand • Improved care in nursing homes • STICS - better management of LTC • RAID - rapid, effective and safe access to mental health services

  6. What can be done in hospital • Ambulatory Care Conditions pathway • GP in A&E? • White board system to track patients • Review spilt of beds between medical and surgical specialties • Rapid response clinics • Psychological liaison service within an Urgent Care hub

  7. Discharge & out of hospital care • Hospital discharge process and communication • ‘Time to think’ beds • Single point of contact for social care • Reviewing current provision of self management education and support

  8. NHS 111 update • National free-to-call memorable number • Single point of contact for urgent care • ‘Talk before you walk’ • NE system is working (unlike others) • Teething problem being ironed out • Opportunities still to be realised

  9. NHS 111 update Patients directed to right services, first time Directly booking appointments into services – including GPs Better use of community services Indentify where gaps in service are

  10. DRAFT URGENT CARE SYSTEM MAP – South Tyneside Urgent Care Delivery Group • STICS (COPD) • STICS (COPD) • Nursing home SLA/ LES • Community matron as care coordinator (evaluation) • Telehealth/ wound sense • DNs/ flu vaccines • Zoning of Urgent Care nursing teams • ACS Pathway review • Single point of contact social care • IRT • Discharge process • Discharge Communication • PPP patients • STICS (COPD) • Nursing Home SLA/ Spec • Pulmonary Rehab • Cardiac Rehab • Pulmonary Rehab • Cardiac rehab • Time To Think beds • Dementia Step up facilities • Perth Green Programme for implement Shared Care Plans Teams involved *A&E *Local Authority *Community nurses (map teams) *Primary Care *Community Nurses (map which teams) *Primary Care *Community nurses (map which teams) *Primary care * Hospital staff * SW team * LA * FT *Rehab teams Tools Risk stratification - (in use in a fragmented way, i.e. separately in FT and Primary Care); not yet in use in LA = opportunity to streamline, agree consistent cohort? e.g. at risk of admission Standard Care Plan – opportunity Standard work – across the pathway for this group involving teams and shared understanding, + time based standards = opportunity (see Nottinghamshire work in progress on frail elderly pathway care standards)

  11. Round Table Discussion • On your tables you will be asked to consider: • Are we on the right lines with our plans? • What else should we be thinking about doing?

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