Media releases

GP commissioners set out ambitious plans for urgent and emergency care in County Durham and Darlington

Clinical Commissioning Groups in County Durham and Darlington have set out ambitious plans to improve urgent and emergency health care for local patients.

The Urgent Care Strategy for County Durham and Darlington 2014-2019 sets out the three CCGs’ commitment to providing 24/7 urgent and emergency care so patients can be seen at the right place, at the right time and by the right health care professional.

Developed by NHS Darlington CCG, NHS Durham Dales, Easington and Sedgefield (DDES) CCG and NHS North Durham CCG in conjunction with local acute hospital and mental health and learning disabilities trusts, NHS 111, the ambulance service, NHS England, local authorities, the police and fire and rescue services and Healthwatch, the strategy looks at increasing demand and aims to address the underlying reasons why patients access services.

It outlines how the CCGs in County Durham and Darlington are considering their approach to urgent and emergency services, with a view to developing services that better meet the needs of their local populations, are easy to access and are financially sustainable in the long term.

The key priorities for each CCG are:

Darlington

  • Bringing Urgent Care and Accident & Emergency (A&E) services together as part of an integrated model at Darlington Memorial Hospital. This work is well underway with the plans for the final physical adaptations on the hospital site in place. It concludes the agreed local vision for delivering urgent care to people in Darlington and will result in an improved experience for patients.

Durham Dales, Easington and Sedgefield

  • The CCG is developing a local strategy that aims to place GP practices at the centre of its primary and community care services, 7 days a week. This includes understanding the urgent care needs of local patients
  • The CCG has commissioned a programme called Experience Led Commissioning which engages local people who use services in the future design of services. This programme will inform the development of the CCGs plans in the next 12 months.

North Durham

  • The CCG has undertaken a review of its in-hours urgent care services and sought he views of patients and the public. The CCG’s ambition is to place GP practices at the core, with access to responsive primary and community care services 7 days a week, including the urgent needs of patients. The CCG has increased capacity and access to GP practices from 8am to 8pm and at weekends to improve outcomes for patients.

Dr Andrea Jones from NHS Darlington CCG, Dr Neil O’Brien from North Durham CCG and Dr Stewart Findlay from NHS DDES CCG said: “All three CCGs recognise that responsive primary care is the foundation of the future health system – including urgent care. It is also recognised that alongside responsive primary care, people need support to help them keep well and effectively self manage their health conditions so that they use urgent and unplanned care services less.

“The aim of the strategy is to bring together these disparate areas to produce a seamless and efficient package of care for the presenting patient.

“To achieve this in County Durham and Darlington a new, comprehensive urgent and emergency care system, delivered by integrated teams of people who share a collective responsibility for every patient journey is needed. This will ensure that urgent and emergency care services that address people’s needs, reduce variation and inequalities, and delivers improved outcomes for patients and the population.

 “This means are alignment of the system to ensure that care is centred around the patient and carer,and achieving a shift from processtoa pathway, which is moreresponsive to the patient need.”

 The CCGs will be engaging with local stakeholders on the strategy and potential models of implementation over the next few months.

 ENDS

 Note to editors

 National Context

The Francis report (2013) calls for a fundamental change in culture in the NHS where by the patients care and safety is put first,with the patient being the priority in everything done.This sets the scene for this strategy, supporting a move to designing services around the patient.

 The NHS Plan (2000) set targets to reduce emergency admissions and to provide patient centred services.

Overall the number of people going to A&E departments in England has risen by 32 per cent in the past decade and by one million each year since 2010. Continuing high levels of demand on A&E and Urgent Care Services have resulted in the current national focus on urgent and emergency care services across England.

A number of reviews have been undertaken including:

  • The Kings Fund ’Urgent and Emergency Care: A review for NHS South of England’ March 2013
  • The Walk in Centre Review: Monitor November 2013
  • Transforming Urgent and Emergency Care Services in England: Urgent and Emergency Care Review, End of Phase 1 Report: High quality care for all, now and for future generations (NHS England 2013).

 Two key factors are clearly identified as contributing to the growing pressures on A&E:

  • An ageing population with increasingly complex needs is leading to ever rising numbers of people needing urgent or emergency care.
  • Many people are struggling to navigate and access a confusing and inconsistent array of urgent care services provided outside of hospital, so they default to A&E.

 A key outcome of the recent reviews indicates that Clinical Commissioning Groups need to ensure the effective use of existing services such as primary care, community nursing, NHS 111 services and other rapid response services as part of their strategies for urgent and emergency care. The Transforming Urgent and Emergency Care Services in England: Urgent and Emergency Care Review, End of Phase 1 Report: High quality care for all, now and for future generations (NHS England 2013) identified five key elements to ensure success:

  1. Provide better support for people to self- care
  2. Help people with urgent care needs to get the right advice in the right place, first time
  3. Provide highly responsive urgent care services outside of hospital so people no longer choose to queue in A&E.
  4. Ensure that those people with more serious or life threatening emergency care needs receive treatment in centres with the right facilities and expertise in order to maximise chances of survival and a good recovery
  5. Connect all urgent and emergency care services together so the overall system becomes more than just the sum of its parts.