NHS England has published an update on its review into Urgent and Emergency Care, led by Sir Bruce Keogh, outlining progress made in implementing the five key recommendations that emerged from Phase 1 of the review.
Providing better support for people to self-care
- Helping people with urgent care needs to get the right advice in the right place, first time
- Providing highly responsive urgent care services outside of hospital so people no longer choose to queue in A&E
- Ensuring that those people with more serious or life threatening emergency needs receive treatment in centres with the right facilities and expertise in order to maximise chances of survival and a good recovery
- Connecting urgent and emergency care services so the overall system becomes more than just the sum of its parts
To achieve those goals NHS England committed itself to certain steps, the progress of which is evaluated in this update:
- Working closely with local commissioners as they develop their five year strategic and two year operational plans: good progress towards that goal has been made, with planning guidance issued to commissioners to support their 2- and 5- year plans, containing information to help them prepare for the introduction of the new system envisaged in Phase 1 of the Review. Moreover, engagement events have been held with commissioners, providers, patients, and wider stakeholders to identify and work through challenges.
- Identifying and initiating transformational demonstrator sites to trial new models of delivery for urgent and emergency care and 7 day services, supported by NHS Improving Quality (NHSIQ): NHS England is currently working with NHSIQ to map out the provided support to local health economies as part of the Integration Pioneer and 7 day services early adopter programmes, aiming to identify sites to test the models and ideas emerging from the Review. This process will also be used to identify areas of the country where the new system will be tested.
- Developing new payment mechanisms for urgent and emergency care services, in partnership with Monitor: the two organisations worked together to redevelop the payment system in a way that would support the Phase 1 proposals, both in the 2014/2015 tariff and the 2015/2016 one.
- Completion of the new NHS 111 service specification so the revised service (which will go live during 2015/16) can meet the aspirations of this Review: NHS England worked with CCGs to produce the standards for an enhanced NHS 111 service, including the refinements that came out of the Phase 1 recommendations. The new commissioning standards will provide NHS 111 clinicians with relevant patient medical information and ensure that patients with a specific care plan are treated according to it, while the service itself must be able to book appointments directly with the corresponding urgent or emergency care service that can deal with the patient’s problem, as well as continue to identify life-threatening problems and dispatch ambulances accordingly. Pilots have been established to test out these new initiatives.
- Working through the NHS Commissioning Assembly to develop and co-produce with Clinical Commissioning Groups the necessary commissioning guidance and specifications for new ways of delivering urgent and emergency care (with this process continuing over the remainder of 2014/15): NHS England has expanded the NHS Commissioning Assembly and continues to work on the development of the guidance on how the urgent and emergency care networks proposed in the end of Phase 1 can be formed and operate. At the same time, tools are being developed for commissioners to better understand the flow of patients in their region, while work is undertaken with Health Education England to extend paramedic training and skills and guidance outlining proposed changes to the ambulance service has been introduced.
The update note suggests that progress is ongoing and further updates will be published as more progress is made.