Agenda

2. Agenda Welcome and introductions 9.15am • What are 111 and the Directory of Services? • Questions and discussion • Demonstration of the Directory of Services Break (15mins) 11.00am • What the Directory of Services means for commissioners • Thinking through commissioners’ processes • Next steps and actions End 1.00pm

4. NHS111 Vision Transforming access to urgent healthcare NHS 111 will make it easier for the public to access urgent healthcare and will drive improvements in the way in which the NHS delivers that care. The NHS 111 Service is specified nationally so that a consistent core identity and quality of service is maintained across the country. The service is commissioned locally by the NHS in a way that is most appropriate for any given area.

5. NHS111 • Political imperative - by April 2013 • Access route to urgent care • To replace NHS Direct • Free to call, three digit number • Get people to the right service first time, including self-care where appropriate • Provide Commissioners with management information regarding usage of services

6. NHS111 Principles • NHS 111 is required to operate according to the following core principles: • completion of a clinical assessment and information on the first call without the need for a call back • ability to refer callers to other providers without the caller being re-triaged • ability to transfer clinical assessment data to other providers and book appointments where appropriate • ability to dispatch an ambulance without delay

7. NHS111 Local Specification BNSSG specification • Core NHS111 services • GP Out of Hours call handling and clinical triage • Dental help line and Dental Urgent Care Emergency Out of Hours Service • Professional SPA

8. NHS111 Procurement Timescales • PCT Cluster Boards to approve preferred bidder with support of Clinical Commissioning Groups - 17 April 2012 to 11 May 2012 • South West NHS 111 Programme Board receives outcomes from Primary Care Trust cluster Boards - 14 May 2012 • Preferred bidders notified - 15 May 2012 • Award contract - 12 June 2012

9. NHS111 BNSSG Project Structure

10. NHS111 Next Steps • Governance/working structure • Project plan • DoS • GP engagement inc GP Clinical Lead • Award contract • Work with Provider re mobilisation • Out of Hours contract

12. The Directory of Services What you need to know! Ross Hamilton – DoS Project Manager

13. Contents • Some Jargon Busting • CMS • DoS • NHS Pathways • How does ‘it’ work? • Example patient Journey • Project Management approach

14. Jargon Busted! The Capacity Management System. • known as ‘CMS’. • It is a web based system developed by NHS Connecting for Health. • It is a suite of modules which measure capacity and activity pressures in real time for urgent and emergency care services

15. Jargon Busted! continued The Directory of Services • also known as the ‘DoS’. This is a module of CMS. • It can be populated with primary and secondary care services including • Community services, minor injury units, district nurses, urgent care centres and emergency dentists and lots more……. • It can record real time activity, skill sets, demographics, referral processes and capacity.

16. Jargon Busted! Continued (2) NHS Pathways • Most likely decision support tool (algorithm) to be used by 111 provider to triage patients who call 111. • It will generate a disposition or ‘DX’ code – this will determine where the patient is directed. • It will allow • Patients to be managed on the phone • An ambulance to be despatched when required • Identify patients for ‘warm transfer’ to clinician call handlers within 111 • Identify those patients who need a local ‘DoS’ service

17. How it works! The Patient Call into 111 Call handler uses NHS Pathways to triage the patient The 111 provider Generates ‘DX’ Code. This will map one of 3 ways 999 111 To the DoS This will hold details of local services The DoS

18. Example patient journey The Patient – Adult, Female, minor wound, North Somerset at 1pm. 1) Call placed to 111 2) Call triaged by NHS Pathways as appropriate for DoS The 111 provider – Wound dressing required, 2 hour response 4) Patient referred to local service The DoS – MIU, Rapid response, Community Ward and ED returned, ranked by commissioner 3) DoS returns appropriate local service with capacity

19. DoS – making 111 safe and effective • The DoS is an ‘enabler’ for 111 which allows the most appropriate community service, with capacity, with the correct skills and within a defined area to be identified This means • NHS Pathways will be able to access each DoS service based on what it is capable of delivering ensuring the patients need is fully met. • This approach ensures patients will not be referred to a service which is inappropriate, closed or does not have capacity.

20. Project Management Approach • BNSSG approach • 111 Project Manager – Fiona Hallaran • DoS Project Manager – Ross Hamilton • DoS Project Support – Peter Purdie • CMS Project Manager – Gavin Reader • Project Board with relevant CCG members • Project Plan in place • Building the DoS – Now • Testing the DoS – July onwards 2012 • Identify Gaps in service – September 2012 • 111 scenario testing – October 2012 • Final testing - February 2013

22. ‘DoS’ in Detail How does it work? Gavin Reader – CMS Regional Lead

23. Contents • DX Code Mapping – What is this? • ‘Live’ Demonstration of the DoS • What is required to populate the DoS? • Responsibilities of the Commissioner • Responsibilities of the Provider

24. DX Code Mapping • Outcomes produced by NHS Pathways after a series of questions have been answered. • DX011 – An Ambulance is being dispatched to arrive within 8 minutes • DX05 – To be seen by a Health Care Professional within 2 hours • DX45 – Provider Service Location Information • There are 78 separate DX codes • Every DX code has been mapped to an outcome • Populate Ambulance Service CAD • ‘Warm Transfer’ to a Clinician in the 111 call centre • Interrogate the DoS

25. Interrogating the ‘DoS’ • ‘Live’ Demonstration of the DOS • How the system works • What is required to populate the DoS? http://www.pcms.nhs.uk

27. Responsibility of the Commissioner (1) DX Code vs Service Mapping Agreed Excel Spreadsheet showing: DX code Explanation of Code Service Service Manager Service Commissioner Have we missed any services? Do we have the right people as Service Manager and Service Commissioner?

28. Responsibility of the Commissioner (2) Approval / Edit rights / Governance Family tree of approval and edit rights per service Commissioner Lead vs Provider Lead Edit & Approval Levels Demographics Capacity recording Clinical Details Service Control

29. Responsibility of the Commissioner (3) Discussion points: Proposal to Meet with Service Providers Contract Additions