At the heart of the Right Care Right Here programme is the transformation of local services, including urgent and emergency care. Urgent and emergency care services provide help and advice and treatment when you need to see a health professional quickly (urgently) for a minor illness or injury, or if you have a serious illness or injury (an emergency).
Our main aim is to develop an emergency and urgent care system that supports the development and delivery of a sustainable system-wide approach to supporting patients in the community as an alternative to non-elective hospital admissions and A&E attendances within the Sandwell and West Birmingham health system.
We know from listening to patients and clinicians that urgent and emergency care services are under increasing pressure and are often confusing for patients. We are reviewing our current services to identify how we can improve care for you. At the heart of our work is the development of the new Midland Met Hospital in Smethwick by 2018. In the next three years we will continue to transform local services, including urgent and emergency care, to prepare for the new hospital.
In developing our proposed vision for urgent and emergency care we have listened to clinicians and patients. We have also taken on board national best practice and recommendations from the Sir Bruce Keogh Review. In 2013 a national consultation, led by Sir Bruce Keogh NHS England’s National Medical Director, was carried out to look at how the NHS provides urgent care.
The national guidance says that all urgent care systems should:
- Provide consistently high-quality and safe care seven days a week
- Be simple, and guide good, informed choices by patients, their carers and clinicians
- Provide access to the right care in the right place, provided by those with the right skills, the first time
- Be efficient and effective in the delivery of care and services for patients.
In February and March 2015 we held a listening exercise to understand what is working well and what can be improved in our urgent and emergency care services locally.
At least 9,415 people were reached through electronic/ postal mailings and distribution of materials within local communities. Discussions took place across 49 engagement activities with approximately 1,105 attendees.
276 survey responses were received and further anecdotal feedback was captured during wider discussions at the various meetings attended.
Feedback from the surveys and engagement events and meetings revealed:
- Ambulance and pharmacy services were highly rated for their efficiency and competent staff
- Seeing the right health professional was more important than a convenient place, time or seeing somebody quickly
- Most people thought they knew enough about where to go when they needed urgent and emergency care. This is positive but it must be built on with good signposting to services and education on how to get the most out of urgent and emergency services for the communities who need services most
- We should invest in information and education but target different communities with different methods such as more information in GP practices in areas where there are older generations and more use of new technologies in areas with younger populations
- Patients wanted improved access to primary care services
- Patients wanted somewhere that was local, open and that they could drop into, not an A&E service, but a large health centre or a walk-in centre
- Patients are open to the use of new technologies, especially younger age groups
- Not enough local people are aware of the Right Care Right Here vision
- Patients asked for better trained and more senior staff
- We should build on any work we have already carried out locally as well as national intelligence, for example, the Keogh review
- Patients want better integration between health and social care.
Following on from the listening exercise, which came to a close on 20 March, and the stakeholder event on 25 March, a collaborative approach to designing urgent and emergency care services was approved by the Right Care Right Here programme partners in April 2015.
Co-designing the future system
On the 30 June 2015 partners across the health, social care and voluntary sector came together to discuss options for the future urgent and emergency care system. In March 2015 partners told us they wanted to be involved in co-designing the future model. Led by our clinical leads Dr Manir Aslam and Dr Sirjit Bath, the event gave everyone the opportunity to discuss a definition for urgent and emergency care and explore future ways of working.
It was great to experience the enthusiasm and energy in the room. Further work is now needed to develop options, which will help us decide what change is needed. If significant change is identified, then we will look to undertake further engagement activity with patients and the public during 2016.
The following themes are being looked at, as part of this work:
The following projects have been identified as part of the scoping with partners:
- Deliver an integrated NHS 111 and out of hours service that optimises the opportunity to maximise clinical expertise and infrastructure
- Sandwell and West Birmingham Hospital Trust will be managing the transition from the two A&E services to the Midland Met A&E and delivery of the Sandwell Urgent Care Centre
- Build on improving ‘same day’ access via in primary care
- Extend the current walk-in centre allowing time to embed improvements to primary care and the introduction of Midland Met Hospital and Sandwell Urgent Care Centre
- Continue to scope the opportunities of delivering improved integrated urgent care services
- Work with West Midlands Ambulance Service to deliver more ‘see and treat’ pathways.
We also know that as part of this work, we will need to:
- Strengthen communications to support education and behaviour change towards urgent and emergency care
- Look at how we can best use IT and technology
- Ensure we have the right workforce to deliver our vision.
Work is ongoing to further develop our strategy for urgent and emergency care. More updates will be added to this page as work progresses.