Two clinical commissioning groups in Cheshire are drawing up plans to set up the first integrated pathway for emergency care, HSJ has learned.

South Cheshire and Vale Royal CCGs have begun consulting providers on the scheme, which they hope will fix the current “fragmented” system.

The CCGs held a “provider day” last month. Those present included private sector organisations, NHS acute, community and mental health providers, and representatives from primary care.

This followed an “invitation to discussion” posted on the Supply2Health website asking providers to take part in a redesign of the local unplanned care system.

Simon Whitehouse, chief officer for both commissioning groups, said existing provision was “fragmented” between accident and emergency services, urgent care centres, out-of-hours provision, NHS 111, primary care and intermediate care.

The redesign will focus on patients admitted to A&E with urgent but not life threatening conditions. “That’s often an extension of what could be delivered or managed in primary care, or would need a further level of diagnostic intervention – it’s that bit that we’re trying to look at,” Mr Whitehouse said. “How do we best manage those patients with really high quality consistent care?”

He said CCGs were keen to involve providers in discussions over how services could best be reshaped.

One “headscratching” element of the redesign was around how to create an integrated emergency pathway without splitting that area of care away from every other.

Mr Whitehouse also said NHS England’s local area team was involved in the discussion, as the main commissioner of primary care. Social care was also part of the discussion, he said, although there were not yet firm plans to pool NHS and social care budgets.