1. Local Care, Local Doctors1 Care on Call - the OOH Service for Kent & Sussex Dr Stephen Bellamy Medical Director – Susdoc

2. Local Care, Local Doctors2 Care on Call - the OOH Service for Kent & Sussex Carolyn Clarke Chief Executive - Maiddoc

3. Local Care, Local Doctors3 Consortium Co-ops 4 separate providers:- TTDOC125,000 MAIDDOC175,000 SUSDOC300,000 MIDSXDOC100,000patients

4. Local Care, Local Doctors4 Consortium Co-ops 4 full cover bases 4 full cover bases 3.5 satellite bases 3.5 satellite bases nurse triage on incoming calls nurse triage on incoming calls paramedic visiting service paramedic visiting service NHSD hub at Maidstone NHSD hub at Maidstone Emergency Care Centre at Maidstone A&E Emergency Care Centre at Maidstone A&E

5. Local Care, Local Doctors5 Where did we start? Written proposal document for the provision of the new service Written proposal document for the provision of the new service Selection process by the PCT Selection process by the PCT 19 th December – selection process complete 19 th December – selection process complete Consortium born! Consortium born!

6. Local Care, Local Doctors6 Managing Change - self Confident and excited Confident and excited Overwhelmed Overwhelmed Support from peers – reassurance Support from peers – reassurance Not alone any more Not alone any more Specialists – more defined roles Specialists – more defined roles

7. Local Care, Local Doctors7 Managing Change - staff Redundancy costs Redundancy costs Consultations with staff Consultations with staff Importance of local knowledge Importance of local knowledge Administratively – jobs for all Administratively – jobs for all Increased responsibility/career opportunities Increased responsibility/career opportunities Important to retain experienced staff Important to retain experienced staff

8. Local Care, Local Doctors8 SO WHAT DO WE DO NOW?

9. Local Care, Local Doctors9 Implementing Change Regular meetings as managers Regular meetings as managers Division of workload Division of workload Involvement of PCT Involvement of PCT Integration with other service providers Integration with other service providers

10. Local Care, Local Doctors10 Care on Call - the OOH Service for Kent & Sussex Jane Harris Nurse Manager – Susdoc

11. Local Care, Local Doctors11 Clinical excellence & Quality Assurance Take approximately 50% calls out of the Co-op Take approximately 50% calls out of the Co-op Resolution rate 65-75% Resolution rate 65-75% Patient & GP satisfaction- Patient & GP satisfaction-  Patient / GP Satisfaction Questionnaires  Nurse Audit Sheets  Voice Recording

12. Local Care, Local Doctors12 Protocols Research Based Research Based Agreed by Medical Directors Agreed by Medical Directors Tool to provide structure to Consultation Tool to provide structure to Consultation Aids Clinical Decision Making Aids Clinical Decision Making Exclude ‘Red Flags’ early Exclude ‘Red Flags’ early Prompt referral if Tel Adv not appropriate Prompt referral if Tel Adv not appropriate ‘Call Back’ ‘Call Back’ Open Door policy Open Door policy

13. Local Care, Local Doctors13 Recruitment & Training Knowledge base and experiences paramount to success Knowledge base and experiences paramount to success 30-40 hours training One-to-One with ongoing assessment 30-40 hours training One-to-One with ongoing assessment Voice Recording used for reflective practice at the end of each session Voice Recording used for reflective practice at the end of each session 3 Formal assessments – 41 separate criteria 3 Formal assessments – 41 separate criteria

14. Local Care, Local Doctors14 The Future Face to Face Consultations Face to Face Consultations Paramedic and Nurse team visiting Paramedic and Nurse team visiting Support to local practices to meet targets Support to local practices to meet targets Travel Clinics / IMMs / Minor Ops Travel Clinics / IMMs / Minor Ops Practice Nurse Bank Practice Nurse Bank