A business critical briefing from HSJ’s Urgent and Emergency Care conference
- Chris Dowse, deputy director - head of urgent care, commissioning and system management directorate, DH
- Simon Eccles, medical director, NHS Connecting for Health
- Paul Mears, chief operating officer, South Devon Healthcare Foundation Trust
- Tracy Parr, Trauma Network development manager, Healthcare for London
- Rick Stern, lead for the Provider Network, NHS Alliance, and partner, Primary Care Foundation
- Jean Challiner, UK medical director, Clinical Solutions
- Stephen Duncan, head of intensive support, NHS IMAS
- Cathy Stuart, assistant director of communications, NHS North West
- Chris Evennett, director of strategy and reform, NHS South Central
- Pat Reid, general manager, Urgent Care
- Jayne Taylor, associate head of leadership development, West Hertfordshire Trust
The challenge of measuring indicators and meeting targets while delivering high quality care, Simon Eccles, medical director, NHS Connecting for Health
- Information is key to delivering high quality care.
- The summary care record looks like it will provide a good foundation.
- Better skill mix in A&E leads to more effective care.
- Review the skill mix in your local A&E departments.
- Understand the status of summary care record adoption.
Achieving integration across primary and secondary care to deliver seamless services in the right place, at the right time, Paul Mears, chief operating officer, South Devon Healthcare Foundation Trust
- Develop a vertically integrated model of care.
- Use patient experience to understand how to develop services.
- Develop a single point of access for patients to ensure ease of access.
- Develop an integrated budget.
- Develop a shared vision.
- Look at the whole system; do not just measure the part that you have changed.
- Review the Kaiser Permanente model.
- Review the possibility of developing an integrated budget.
- Review patients’ comments about what they find challenging about access to services.
Overhauling stroke and major trauma care to improve care delivery and reduce pressure on other NHS services, Tracy Parr, Trauma Network development manager, Healthcare for London
- Wide engagement is key - when services in London were reconfigured 31 PCT stakeholders agreed on the general principles.
- Good clinical engagement is also important - a clinical expert panel was used in London to gain consensus around clinical pathways and standards.
- Training staff so they understand new systems is also crucial.
Interactive Discussion - exploring new models of care to transform your whole health economy, Rick Stern, lead for the Provider Network, NHS Alliance, and partner, Primary Care Foundation
- Service changes need to be evidence based.
- Whole pathways across services need to be looked at.
- Primary care and secondary care need to work together.
- Different models of delivering primary care were addressed, such as GPs working alongside A&E teams.
- Change should be driven by increasing quality and improving patient safety not just saving money.
Understanding the role of the Emergency Care Intensive Support Team, Stephen Duncan, head of intensive support, NHS IMAS
- Data can provide insight into what is happening in the service.
- Sustainability is important.
- Managers should consider reviewing DH and SHA data.
- Managers should evaluate operational trigger points.
Recruiting and retaining a high quality workforce by investing in their ongoing development, Pat Reid, general manager, Urgent Care, and Jayne Taylor, associate head of leadership development, West Hertfordshire Trust
- The trust had an opportunity to design a service from scratch with new roles and new models of care.
- They developed a multidisciplinary team that really worked together.
- A year in advance they swapped nurses between two hospitals to try to prevent cultural problems.
- They removed the role of bed manager - the wards managed patient flow themselves.
- Therapists became involved in discharging and they had extra social workers on wards to help discharge patients.
- Managers should consider making contact and going to see the unit.
Using social marketing to alter behaviours and ensure patients receive the right care in the most appropriate setting, Cathy Stuart, assistant director of communications, NHS North West, and Chris Evennett, director of strategy and reform, NHS South Central
- The speakers undertook a study to understand reasons for hospital attendance.
- The social marketing team developed a communications pack that could be adapted for use by different services.
- This encouraged the organisation to pool resources and maximise the impact of the campaign.
- There is no point in changing services if patients are not clear about the changes or how to use services.
- Managers should consider using social marketing in tandem with service redesign.
Michaela Firth is a programme manager at NHS South Central.
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Urgent and Emergency Care - conference sessions