Jarrow NDUC – North Scotswood Eston Grange Vocare North East Locations NDUC - Tees

North East Operations Centres

Northern Doctors Urgent Care North East Ambulance Service North East NHS 111 Service

North East NHS 111

million£23 million Vocare Group Facts

Northern Doctors Urgent Care

GP Led 7 GPs in Senior Clinical Management Team 24/7 Clinical on Call Integrated Group Clinical Review

Tees March 2013 NQR Performance NQR1Service Monitoring and Data ReportingNumber of working days following end of relevant month for service to produce report100% NQR2CommunicationPercentage of details of OOH patient consultations (including clinical information) transmitted to the GP practice where the patient is registered by 08:00hrs the next working day. 100% NQR8aInitial telephone callPercentage of calls engaged (no more than 0.1%)100% NQR8bInitial telephone callPercentage of calls abandoned98% NQR8cInitial telephone callPercentage of calls answered within 60 seconds of the end of the introductory message (maximum 30 seconds for introductory message) 96% NQR9aTelephone clinical assessmentPercentage of patients suffering from immediate and life threatening conditions whose calls are passed to the ambulance service within 3 minutes of their condition being identified. 100% NQR9bDefinitive clinical assessment -telephonePercentage of urgent calls where definitive clinical assessment is started within 20 minutes of the call being answered by a person 100% NQR9cDefinitive clinical assessment -telephonePercentage of all other calls where definitive clinical assessment is started within 60 minutes of the call being answered by a person 96% NQR10aFace to face clinical assessmnetPercentage of patients suffering from immediate and life threatening conditions whose are passed to the ambulance service within 3 minutes of their condition being identified. 100% NQR10bDefinitive clinical assessment -face to facePercentage of patients with urgent needs where definitive clinical assessment is started within 20 minutes of the patient arriving at the centre. 100% NQR10cDefinitive clinical assessment -face to facePercentage of all other patients where definitive clinical assessment is started within 60 minutes of the patient arriving at the centre. 100% NQR12aFace to face consultations (either in a centre or in the patient's place of residence) Percentage of patients whose face to face consultation (following definitive clinical assessment) takes place within 1 hour (where classed as an emergency) 100% NQR12bFace to face consultations (either in a centre or in the patient's place of residence) Percentage of patients whose face to face consultation (following definitive clinical assessment) takes place within 2 hours (where classed as urgent) 97% NQR12cFace to face consultations (either in a centre or in the patient's place of residence) Percentage of patients whose face to face consultation (following definitive clinical assessment) takes place within 6 hours (where classed as less urgent) 99% NQR13Access to interpretation servicesPercentage of patients who are unable to communicate effectively in English provided with an interpretation service within 15 minutes of initial contact. 100%

Audit NHS Tees A&E Audit carried out by Dr Peter Haywood NHS Tees Period 10 June 2013 to 17 June 2013 NDUC A&E/999 Audit carried out by Dr Edward Summers NDUC

Outcomes – A&E 2857 Total A&E Attendances 25 NDUC A&E/999 referrals to A&E 922 NDUC Cases 0.88% of A&E Attendances 2.71% of NDUC Cases NDUC Non NDUC

Outcomes – Admissions (not A&E) 7.5% of NDUC cases this week 5.4% of NDUC cases July 2013

Total Secondary Referrals (Admissions + A&E/999) National 12-16% (Primary Care Foundation Report of April 2012) NDUC 10% (NDUC Internal)

999 Cases complicated distressed acute retention of urine following cystoscopy that day lab result indicating a heart attack cardiac chest pain with history of previous heart attack ?stroke cardiac chest pain and difficulty in breathing significant overdose of painkillers

A+E Cases 3 arranged after face to face assessments – 92yo fall, 93yo fall, 11yo wrist injury after discussion with A&E Consultant 3 sent to A&E after discussion with district nurses regarding patients with catheter problems 2 patients elected to attend A&E despite offer of centre appointment 1 patient sent to A&E after discussion with Gynaecology on call

A+E Cases 1 patient called ambulance prior to NDUC Dr telephone assessment 1 patient assessed at 2300hrs with eye symptoms – referred to Eye Casualty Clinic the next morning 6yo with needle stick injury from syringe on allotment 32yo with malaena (significant stomach bleeding) Severe abdominal pain with pain score 10/10

A+E Cases abdominal pain incarcerated hernia 12m baby vomiting x40 over 34hrs Suspect ectopic pregnancy/miscarriage Unwell infant ?Croup

Total Secondary Referrals (Admissions + A&E/999) National 12-16% (Primary Care Foundation Report of April 2012) NDUC 10% (NDUC Internal)

2012/13

Moving Forward Paramedic Support Special Patient Notes Access to GP Patient Records CREAM (Clinical Review Evaluation and Assessment Meetings) SERRG (SEcondary Referral Review Group)