111 - A Better Way to Access Urgent Care

What is Urgent Care? Not a life-threatening emergency BUT: “The range of responses that health and care services provide to people who require - or perceive the need for - urgent advice, care, treatment or diagnosis.”

The Ideal: People are frustrated by delays in getting the services they need when they need them, by duplication between services and being passed from one service to another, by having to repeat basic information about themselves and some groups remain disadvantaged in their access to care. People should expect 24/7 consistent and rigorous assessment of the urgency of their care need and an appropriate and prompt response to that need. The Current Situation:

Patients Interface with Current Urgent Care Services? ? Minor Injuries Unit Urgent Care Centre GP-led walk-in centre Walk-in Centre NHS Direct 999 A&E GP Practice GP Out-of-Hours Pharmacist Community Services e.g. district nurses Mental Health Crisis Teams Midwifery Services Health website

How Does 111 Improve Access to Urgent Care Services? Providing an easy to access and remember phone number Using A Consistent Approach to Assess Health Needs (NHS Pathways) Creating an Electronic Skills-based Directory of Services Over Time Urgent Care Providers Will Work More Closely Together

111 – An Easy Point of Access NHS Direct (for routine health information and advice) GP (in-hours and out of hours) (for emergencies) Single Assessment Directed to appropriate help: GP (in hours and OOHs) Community-based service Walk-in centre Self care Midwife Transferred to 999 if it is actually an emergency ? Other Community Services

Improving the public’s access to urgent health care services Increasing the efficiency of the NHS by ensuring that people are able to quickly and easily access the urgent health care services that is most appropriate to their needs Increasing the efficiency of the 999 emergency ambulance service and Emergency Department Enabling the commissioning of more effective and productive healthcare services that are tuned to meet people’s needs Benefits

A Possible Scenario Now An 85-year-old man wakes up in the middle of the night in pain and discomfort because his catheter is blocked. Living on his own and unsure of where to turn to for help he dials 999 and an ambulance arrives at his home after about half an hour. The crew takes him to the local A&E department where he is seen within four hours and is admitted for an overnight stay. Unfortunately, while he is on the ward he gets an infection and has to stay in hospital for a further week before he is discharged home.

A Better Scenario with 111 in Place An 85-year-old man wakes up in the middle of the night in pain and discomfort because his catheter is blocked. He knows about the 111 phone number for urgent care and dials it. The call handler assesses his needs and, because there is a comprehensive directory of services available, is able to get in contact with a local out-of-hours district nursing team. Within an hour a district nurse arrives at his home and unblocks the catheter.

Next Steps Complete the Population of the Directory of Services Training of 111 Providers on NHS Pathways Stakeholder Engagement ‘Soft Launch’ by Putting GP OOHs Calls Through the NHS Pathways and Directory of Services Environment Marketing and Launch of 111 Evaluation (and Further Roll Out in the East Midlands)

Thank you Any Questions?