In July 2015, NHS England and its national partners announced a new type of new care model vanguards.
There are eight urgent and emergency care vanguards which will improve the coordination of urgent and emergency care services and reduce the pressure on A&E departments.
These vanguards were selected following a rigorous process, involving workshops and the engagement of key partners and patient representative groups.
Latest information on NHS England’s urgent and emergency care review can be found on the NHS Choices website.
Urgent and emergency care – new approaches to improve the coordination of services and reduce pressure on A&E departments
The below are urgent and emergency care vanguard sites:
- Greater Nottingham System Resilience Group
- Cambridgeshire and Peterborough Clinical Commissioning Group
- North East Urgent Care Network
- Barking and Dagenham, Havering and Redbridge System Resilience Group
- West Yorkshire Urgent Emergency Care Network
- Leicester, Leicestershire & Rutland System Resilience Group
- Solihull Together for Better Lives
- South Devon and Torbay System Resilience Group
The Greater Nottingham System Resilience Group (SRG) is made up of more than a dozen local partners.
These include Nottingham University Hospitals NHS Trust, the South Nottingham and Erewash clinical commissioning groups, Nottingham city and county councils, East Midlands Ambulance Service (EMAS ), Nottingham CityCare Partnership, County Health Partnerships, Nottinghamshire Healthcare NHS Foundation Trust, Derbyshire Health United Ltd (111 provider), Nottingham Emergency Services (GP out of hours), Healthwatch Nottingham and Healthwatch Nottinghamshire.
The vanguard will support ambitious improvements in urgent and emergency care for the citizens of Greater Nottinghamshire. Partners will look at what more they can do, using innovative workforce solutions to ensure that people receive care in a timely way and closer to home – in many cases avoiding the need for assessment or admission to hospital.
Work will focus on:
- Enhancing mental health services in the community to give patients the care they need, in the best place in a timely manner. This will include rolling out and extending the national mental health 111 pilot to provide faster and better care when it is needed.
- Improving access, clinical assessment and treatment to primary care clinicians at the ‘front door’ of the emergency department so that patients are assessed and then followed up closer to home.
- Enabling more direct clinician to clinician conversations so that more patients are directed to the right service, first time, every time.
The system will involve patients, carers and wider partners in its improvement to lead the way in providing ever more timely and safe emergency care.
Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) has three system resilience groups (SRGs) and is part of the East of England Urgent and Emergency Care Network.
The CCG’s vision is to create an overarching super SRG with strong clinical leaders, as part of the existing network.
As a UEC Vanguard the CCG aims to accelerate improvements and develop a best practice model for urgent care services which helps address variations in access to services and health inequalities in the region.
The ‘super SRG’ will focus on:
- Promoting self-care and management.
- Helping people with urgent care needs get the right advice first time and access the right service seven days a week.
- Providing highly responsive urgent care services outside of hospital.
- Developing a workforce to meet these needs including GP fellows, advanced nurse practitioner and advanced AHP roles, developed community pharmacist roles, physician’s assistants and staff equipped to meet mental and physical health needs.
- Reassessing service standards based on outcomes and redefining payment methods to incentivise system redesign.
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Participation by the North East Urgent Care Network (NEUCN) in the vanguard programme will benefit the whole of the North East region.
This covers areas around Northumberland, Tees, Esk and Wear Valley, Newcastle, Northumbria, Gateshead, Tyneside, Sunderland, County Durham, Darlington and Hartlepool – a region with a population of 2.71 million. It is made up of three major conurbations, and spreads across both urban and rural areas.
The NEUCN – which consists of all the key physical, mental health and care stakeholders and providers – already has a strong history of working collaboratively to deliver successful innovative projects to support the recommendations made in the Urgent and Emergency Care Review as well as, importantly, improving patient outcomes and experience.
This programme will enable the network to transform the regional UEC system and its services to further improve consistency and clinical standards, reduce fragmentation and deliver high quality and responsive health and social care to patients.
It will also enable them to move at pace in terms of creating and implementing one urgent and emergency care model as well as giving strategic oversight to urgent and emergency care services across the regional footprint, providing consistent and seamless care, wherever patients present, whatever the day or hour with no difference in the clinical outcomes delivered.
Barking and Dagenham, Havering and Redbridge System Resilience Group aims to create a simplified, streamlined urgent care system delivering intelligent, responsive urgent care for 750,000 residents in the most challenged health economy in the country.
The SRG believes there is a need to do things differently and that patients are confused by the many and various urgent and emergency care services available to them – A&E, walk-in centre, urgent care centre, GPs, pharmacists, out of hours services.
Becoming a UEC vanguard will support the SRG in its ambition to streamline these points of access to just three – supported by a smart digital platform that will recognise patients and personalise the help they get as soon as they get in contact. This involves:
1. ‘Click’ – online support and information will help people to self-care and book urgent appointments when needed.
2. ‘Call’ – telephone for those who need more advice, reassurance or to book-in.
3. ‘Come in’ – where patients really need emergency care the front door of the hospital will become our new ambulatory care centres.
This ambitious plan is being developed with patients and staff, and will be implemented by building on existing successful partnership working between NHS and social care organisations across the three boroughs.
Established in 2014, the West Yorkshire Urgent and Emergency Care Network vanguard covers Leeds, Bradford, Calderdale, Kirklees, Wakefield and Harrogate. It serves a population of around three million people.
The Vanguard will work with partners, including five local system resilience groups, to build on progress already made in transforming primary, community and acute care services.
Yorkshire Ambulance Service will develop a stronger focus on becoming a mobile treatment service delivering care at patients’ homes with conveyance to hospital for those who really need to go.
Three mental health service providers will work with West Yorkshire Police to deliver major service change which will see rapid crisis response through emergency response control centres and ‘street triage’.
Other planned projects include creating an Integrated West Yorkshire Care Record and a system-wide information dashboard which reports in ‘real-time’.
The Leicester, Leicestershire & Rutland System Resilience Group (SRG) vanguard covers the city of Leicester, counties of Leicestershire and Rutland and surrounding towns, serving a population of 1.1 million people.
The vanguard will create a new alliance-based urgent and emergency care system where all providers work as one network. This will bring together ambulance, NHS111, OOH and single point of access services to ensure that patients get the right care, first time.
The network will include a same-day response team with GPs, acute home-visiting and crisis response services, community nursing, older people’s assessment unit and urgent care centres.
University of Leicester Hospitals NHS Trust (UHL) runs the largest single site A&E department outside London. In 2016, the hospital’s urgent and emergency care front door will be re-launched to include an assessment team with the ability to refer patients to ambulatory clinics, assessment beds, on-the-spot urgent care centres or primary or community care.
Solihull Together for better lives partnership comprises the Heart of England NHS Foundation Trust, Birmingham and Solihull Mental Health NHS Foundation Trust, Solihull Metropolitan Borough Council, NHS Solihull Clinical Commissioning Group, primary care, and lay members representative of the Solihull population.
The partnership will create an integrated health and care system that extends healthy active life and optimises preventative out of hospital care with rapid access to specialist care. This will be both in and out of hospital when needed, including access to other wellbeing services both at the hospital and in the community.
This will involve building an urgent care centre within the hospital site capable of delivering a minor illness and minor injury service in line with the description of urgent care centres given within the Keogh report, which includes GP out of hours, urgent primary care and minor injury services.
Redesigning care models for older people – from prevention and early intervention through to end of life care – will alter the balance of care provided in both hospital and the community, reducing pressure on secondary care services.
South Devon and Torbay’s vanguard is led by South Devon and Torbay Clinical Commissioning Group, South Devon Healthcare Foundation Trust and Torbay and Southern Devon Health and Care Trust, on behalf of the local system resilience group, which also includes Torbay Council, South Western Ambulance Services Foundation Trust, Devon Doctors Ltd and community pharmacy.
The group will serve a mixed urban and rural population.
The vanguard will develop new urgent care centre facilities at pace in at least two areas, prioritising those of higher deprivation to reduce inequalities.
To make the best use of the resources spent locally on urgent and emergency care and avoid duplication, primary care facilities will be co-located with A&E and urgent care centres in at least two locations, and primary care records will be shared with the out-of-hours provider.
Vanguard site selection event
Urgent and emergency care vanguards are developing new approaches to improve the coordination of urgent and emergency care services and reduce pressure on A&E departments.
In mid-July 2015, the new care models team hosted an event to select the successful urgent and emergency care vanguards. This included a range of key partners and patient representative groups. You can watch the presentations of the shortlisted organisations on NHS England’s YouTube channel.