Urgent and Emergency Care: A Whole System Approach

Key Contributors

• Led by Dr. Agnelo Fernandes, with contributions from various experts across healthcare sectors.

Overview and Purpose

• Urgent and emergency care guide aimed at improving commissioning practices.
• Emphasizes integrated, seamless care involving GPs, specialists, local authorities, and the third sector.
• Acknowledges the intertwined relationship between physical and mental health.

Importance of Urgent and Emergency Care

• Accounts for significant portions of A&E attendances and readmissions.
• Mental health issues constitute a notable percentage of these attendances.
• Children and young people represent a large demographic in emergency services.

Principles of Effective Commissioning

• Community-focused, clinically-led, collaborative, and comprehensive.
• Prioritizes integration across healthcare sectors to address both physical and mental health.
• Patient satisfaction and staff satisfaction are key indicators.

Current Challenges and System Fragmentation

• Fragmented urgent and emergency care services cause confusion.
• Need for a coherent 24/7 urgent care service.
• Importance of reducing emergency admissions and improving patient pathways.

Clinical Commissioning Cycle

1. Analyse and Plan: Assess patient and population needs.
2. Design Pathways: Develop integrated care pathways.
3. Specify and Procure: Contract for services based on evidence.
4. Deliver and Improve: Ongoing monitoring of service quality and patient satisfaction.

Case Studies and Evidence

• Real-life examples illustrating the need for integrated care solutions.
• Highlights patient journeys and the benefits of coordinated care.

Quality, Innovation, Productivity and Prevention (QIPP)

• Aims to reduce ED visits and improve healthcare efficiency.
• Encourages innovations like NHS 111 for streamlined patient access.

Role of Primary Care

• Critical in preventing emergency care through anticipatory and self-care strategies.
• Primary care teams need to adapt to new models of urgent care delivery.

Enablers and Strategic Directions

• Use of NHS Pathways and Capacity Management Systems.
• Integration of services across health and social care sectors.
• Development of Clinical Commissioning Groups (CCGs) for strategic planning.

Monitoring and Evaluation

• Emphasizes continuous service monitoring and quality assurance.
• National clinical indicators guide assessment of service effectiveness.

Conclusion

• A unified urgent and emergency care system can lead to better patient outcomes and service efficiencies.
• Collaboration across disciplines and sectors is essential for effective service delivery.

For Further Information

• Contact RCGP Centre for Commissioning for resources and guidance on implementing these strategies.