To consider progress in delivery of an integrated urgent care pathway.

The report highlighted the clinical commissioning group’s aspiration to improve the urgent care pathway as the number of routes in to care could be confusing.   Whilst there was a main focus on A&E waiting times, that was just one indicator of a positive experience and the impact on urgent care had an impact on surgery. The intention was for people to be seen more quickly and locally and to ensure that they know where to go for care. There was opportunity to review some provider contracts in 2016. Outcomes would consider the whole care pathway including preventive work.

The sharing of records was a factor in joining services up to provide a better care pathway with more visible information between professionals, although information governance and safeguarding issues were taken into consideration. 

Feedback was also that people wanted to live independently for as long as possible. This would be a factor in selecting providers who could meet that outcome such as through prevention work. This approached was mirrored in NHS policy and so there was more evidence that this was the right direction. 

A workshop was being planned for clinicians to consider three work strands:

•           7-day primary care to reduce the need to come to A&E. Data suggested that the GP was the first port of call and the impact of this on other providers needed assessing;

•           locality based services and realigning community services – providing opportunity to move to public centred care to get best outcomes;

•           building in integrated care and understanding the link with intermediate care and primary care.

Board members made the following comments and observations about this update:

•           communication was important for communities to have an idea of what they could access and opportunity to re-engage on the new model;

•           there was a disconnect which needed review to ensure that walk-in centres had access to records;

•           if it were the preferred approach to meet public demand for 7-day access to primary care, there would need to be a review of capacity and implications for other provisions;

•           no decision had been made regarding decommissioning other services and any such decisions would be the subject of consultation;

In terms of a timescale, if the CCG needed external assurance that the proposals were clinically sound, this would add 3 months onto the process and so implementation could be next summer.

The CCG was commended for the considerable engagement on this matter; there were different models to provide this pathway but it was believed that the public would welcome the improvements.  

It was acknowledged that consultation could always be improved upon and there would be investigation into whether the responses could be analysed by age group.

It was noted that clear outcomes were evident and that this was helpful to the success of the project.

RESOLVED

THAT:

(a)        the integrated urgent care pathway plans (at appendix 1) are reviewed; and

(b)       the board identifies any areas for further focus or additional actions to secure improvement.