The other crucial parts of the hospital trust urgent care system are acute medicine, surgery and orthopaedics. The acute trust receiving and assessment function of these departments should be seamlessly integrated with the A&E majors or non ambulatory process. Trusts and local commissioners should agree a set of process and quality metrics which ensure patients are assessed rapidly by senior staff after arrival and then have rapid access to appropriate diagnostics followed by a senior decision within a 2-3 hour window for the whole episode. The outcomes after this process will be a range of local options. What is not in doubt is that rapid senior assessment and treatment results in improved outcomes. The range of quality metrics should focus on clinical processes and outcomes.
In addition, the acute trust should ensure there is a positive and clinical dialogue between admitting doctors and the senior receiving doctor at the point of referral. For too long the process of admission has been reduced to an administrative process via a bed bureau. The improved process will allow a more sensitive and appropriate plan to be developed for the patient in advance of arrival at the hospital and indeed may allow the utilisation of alternatives such as rapid out patients or community and ambulatory based alternatives to admission.
The relationship between the emergency department and the rest of the hospital is a crucial interface in the urgent and emergency care pathway and tends to be put under particular strain when the emergency department is under pressure or struggling to treat people rapidly..
The Primary Care Foundation was established to support the development of best practice in primary and urgent care. The three Directors bring different skills and perspectives to understanding primary and urgent health care - for more details click below:
We also work with a number of associates
The benchmark of out of hours services has been published. To interact with the data and download reports CLICK HERE. To read the overall analysis of the findings CLICK HERE. The benchmark covers more than two thirds of the PCT areas in England and, for the first time, participants have agreed that the data should be published in a way that allows individual services to be identified. To read the press release CLICK HERE.
Rick Stern is to take up the role of Chief Executive of the NHS Alliance from 16 April 2012. He will still be working for half the week as a Director of the Primary Care Foundation
Our latest report ‘Breaking the mould without breaking the system: new ideas and resources for clinical commissioners on the journey towards integrated 24/7 urgent care’ is now available to download CLICK HERE. It is published in partnership with the NHS Alliance and will be formally launched at a session at the NHS Alliance annual conference in Manchester on 1st December 2011.
We are working with increasing numbers of practice to improve access and urgent care in general practice. If you would like to know more about our web based tool and customised reports based on a week of practice data and join over 300 practices across the UK,please email Rick Stern at rick.stern@primarycarefoundation.co.uk
For an independent view of our work with practices on access and urgent care CLICK HERE for the article in the HSJ on 24th November 2011
4th round of the out of hours benchmark. You should be receiving final data for validation soon and the first open set of openly available results will be available from this website in April 2012.