New Opportunities

For Practices to audit their appointments and

For local health systems to shape their integrated urgent care system

A&E and Acute Medicine

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.

About Us

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:

David Carson

Rick Stern

Henry Clay

 

 

Latest News

Are there any simple lessons for practices looking to improve access?

A new feature article in Management in Practice by Rick Stern reviews what we have learned from working with over 1,500 practices across the UK – you can read the full article HERE  

 

Integrated Urgent Care – how to make NHS 111 work

A lead article for Health Care Leader by Henry Clay describes a financial and capacity model developed for NHS England, the potential benefits and pitfalls, and what we have learned from working with a dozen areas to apply the model. The article is available at HERE and a fuller version with a number of explanatory graphs can be downloaded HERE

 

A new audit of potentially avoidable appointments in general practice – available to all practices at no cost

This audit was developed as part of our research for NHS England with the initial results - suggesting that 27% of GP appointments are potentially avoidable - published in ‘Making Time in General Practice’. NHS England are now committed to extending this work by funding support for practices - so there is no direct cost - of an App you can download on to your computer screen, making it really easy for you to see how many of your appointments might be avoidable and helping you explore how you might be able to do something about it. If you want to know more, download Frequently Asked Questions, the Governance Statement and the Application Form and take a quick look at a virtual tour or email us at This email address is being protected from spambots. You need JavaScript enabled to view it.

  

Integrated Urgent Care – opportunity for support to your locality

We have developed a financial model for the Integrated Urgent Care Team at NHS England that focuses on the NHS 111 and OOH ‘front end’ to an integrated urgent care system (but also looks at the cost of onward referrals to other services). This is proving to be an invaluable tool for both commissioners and providers. It is now available to use and NHS England have also agreed to support some sites to setup and work through the model with PCF’s Henry Clay who developed the model. For further information please contact Henry on This email address is being protected from spambots. You need JavaScript enabled to view it.

 

We are now supporting over 1,500 practices across the UK to manage access and urgent care

Our support for general practices looking to improve access for patients and streamline the management of urgent care continues to expand. Based on a web based tool, developed out of our work commissioned by the Department of Health, we collect practice data for one week and prepare a report for each practice looking at how you compare to others and explore what this means for making practical changes in the way you work. We are regularly improving the format of our reports for practices based on constant feedback. If you would like to see an example report, CLICK HERE.  If you want to know more about how we might work with you please contact Rick Stern on  This email address is being protected from spambots. You need JavaScript enabled to view it.  or call on 07709 746771.