1. Unscheduled Care Regional Taskforce Out Of Hospital Workstream Dean Sullivan / Pat Cullen

2. Out of Hospital Workstream – Key Priority Areas 1.Nursing Support to OoH Services 2.Improved Utilisation of Minor Injuries Units 3.Enhanced GP capacity for Home Visits 4.Introduction of Alcohol Recovery Centres.

3. 1.Nursing Support to OoH service Enhance the nursing response to OoH services for palliative patients, reducing the potential for presentation at ED and unnecessary admission, resulting in Right Care in the Right Place by the Right Staff Partnership with Marie Curie to provide specialist nurses – embedded within OoH GP Services Enhanced current service in Northern and Southern Trust areas (previously Night-time service only) Introduction of new service in Northern sector of Western Trust (12months)

4. Nursing Support to OoH service Commenced 1 st January 2015 Fully operational 14 th March 2015 Partnership with NIAS-Palliative Care protocol developed ‘Go-Live’ Date 20 th April

5. Nursing Support to OoH service: Impact to date Trust Area January 2015February 2015Total to date Visits CallsVisits Calls Northern – new weekend PH day (not including existing night time service numbers) 24 11 22 1471 Southern– new weekend PH day -(not including existing night time service numbers) 13 30 20 1982 Western –7 day Night time service introduced. Daytime /PH service due to commence mid March 15 38 40 63 25166 Total758110558319

6. 2.Minor Injuries Units Development of shared protocols with NIAS Operational since November 2014 Encouraging better flow of patients towards utilising MIUs Reduced unnecessary ED attendances More Streamlined service for non-urgent service users

7. 3.Enhanced GP Capacity To facilitate more timely home assessments Earlier visits can facilitate easier access to services Potential to negate the need for transfer to ED Potential to ensure smoother flow of patients to ED resulting in fewer late afternoon peaks in urgent referrals

8. Enhanced GP capacity Commenced November 2014 351 GP practices availing of enhanced service running from November 2014-March 2015

9. 4.Alcohol Recovery Centres To explore and test appropriate alternatives to ED for patients under influence of drink/drugs. To provide limited minor injuries services Distribute food and rehydration for intoxicated individuals in a warm, comfortable and safe place – thus assisting with better assessment Blood Pressure and Sugar level monitoring

10. Alcohol Recovery Centres Needs Assessment Undertaken Service Specification prepared Discussions with key partners underway Implementation arrangements being finalised

11. Conclusion and Next Steps Range of measures established in ‘out of hospital’ settings Further opportunities to integrate services GPs/OoH/NIAS/3 rd Sector/Trusts Particular focus in 2015/16 for ICPs