Urgent Care North Somerset Clinical Commissioning Network

1. Urgent Care North Somerset Clinical Commissioning Network

2. Introductions • Dr. Kevin Heggarty – Chair, North Somerset Urgent Care Clinical Network • Mark Hemmings – Urgent Care Programme Manager, SW Commissioning Support

3. Our Sessions Session 1: Urgent Care animation Challenges and plans! Q&A: listening to your experiences 10 minute break Session 2: Group work Exploring case studies to identify what could add value to the patient experience. The outcomes of this session will help to inform future priorities and planning.

4. Session 1 Setting the scene……. “Urgent Care” – a helpful animation produced by The Kings Fund

5. Transforming Urgent Care: Resources Demand Complexity

6. Real net spending on UK NHS

7. Zero growth until 2017 2017

8. Rising Demand • Demographic change • Medical advances • Patient expectation • Failure demand • Lifestyle

9. Care mountain High risk Cost Low risk Demand

10. Patient System Funding

11. http://www.awp.nhs.uk/ Weston (North Somerset) Urgent Care Working Group Primary Care, Voluntary Action NS, Lay member, Somerset CCG = 14 organisations represented

12. Design principles: Consistent Simple Right first time Efficient and effective

13. ED front door streaming. • Building a community infrastructure. • ABC raising awareness campaign • Geriatrician team • Care Home Support • 7 day working • Enhanced ambulatory care

14. Creating a constantly improving system • Clinical engagement • Alamac dashboard • Building relationships • Incident reporting • Clinical audits • Patient experiences

15. Q&A: Your experiences of urgent care Questions? Experiences? During this session we will try to capture the main points of your experiences and, if possible, use in Session 2 to explore further

16. Session 2 • Format - 2 facilitated groups exploring different case studies • Ground rules • Key questions: • What went well? • What went wrong? • What could have been done differently? We should be continually striving to add value for the patient and eliminate waste

17. What next? • We will capture “What you said…..” and put together all your comments, suggestions and ideas. These will be included in the event feedback. • Your comments will also be really useful to help shape future priorities and plans Thank you! 10 minute break then regroup in Red Room

18. Case study 1 • Working age man • Lives with family • Develops cough, has discomfort and generally doesn’t feel great • Wants GP appointment but can’t afford to take a half day off work • Struggles through week • On Saturday calls the Out Of Hours doctor • Told to go to a primary care centre • Diagnosed with a chest infection • Needs tests – admitted to hospital

19. Case Study 2 • Mum of young children • No extended family locally • Toddler 18 months consistently at GPs with “fevers” • Beginning of Tuesday, toddler is again unwell by evening hot and crying constantly • Calls ambulance • Paramedic attends • Toddler taken to Bristol Children’s Hospital for assessment • Siblings cared for by neighbour

20. Case Study 3 • 36 year old female • History of alcohol and drug misuse • Recently come out of rehab centre • Relapses - starts drinking again • Using benzodiazipines • Goes to GP who prescribes Diazepam • Regularly going to ED in agitated state sometimes intoxicated sometimes in withdrawal from alcohol

21. Case Study 4 • 86 year old man living alone • History of • Seen GP • Booked to haver injection fiollowing week • Pain continues and makes immobile • Phones 999 for ambulance • Taken to hospital • Seen by ED team but relatively junior doctor • Suspected DVT – admitted to hospital • Stays in several days • Discharged with pain relief but less mobile