Urgent and Emergency Care

Short Term

• Through surge management and escalation, continue to manage the ongoing Covid-19 demand by separating emergency patients, both in the Emergency Department and the Acute Medical Units, using isolation strategies, as well as managing other emergency demand working in partnership with all partners including the ambulance service, mental health, the county councils and Clinical Commissioning Groups. 

Medium Term

• Develop and expand services to optimise capacity to cope with increasing levels of emergency demand (both Covid-19 and non Covid-19) as well as sustain high levels of elective activity to continue to reduce backlogs and waiting times.

Long Term

• To actively work across the system to put in place services that meet best practice standards and benchmark well nationally, in terms of their environment, levels of service provision and staffing resource.
•  To achieve safe and responsive 24/7 urgent and emergency care made up of a comprehensive range of services.
• To provide urgent access to primary care illness and injury services in the community, effective triage and signposting services (i.e. NHS 111 online, NHS 111 Clinical Assessment Service, Clinical Advice Lines in secondary care), timely emergency/crises response services including ambulance, community and mental health crises, robust acute emergency and trauma care.
• To have in place real-time and accurate intelligence and information datasets to inform surge responses, forecasts, and future planning.
• Adults, children, and young people experiencing mental health crisis will be able to access the support they need – single point of access through NHS 111, access to crisis care 24/7 and intensive follow-on to reduce future use.
• Ambulance services, to be at the heart of the urgent and emergency care system, providing timely responses with patients treated at home or in more appropriate care settings outside of hospital. Ambulance staff will also be trained and equipped to respond effectively to mental health crisis, including mental health transport, mental health nurses available for ambulance EOC, and mental health training for front-line crews.
• To improve responsiveness of community health crisis response services to deliver the services within two hours of referral in line with National Institute for Health and Care Excellence (NICE) guidelines.
• To ensure all parts of the County are delivering reablement care within two days of referral.
• To provide enhanced health in care homes – upgrade NHS support to all care home residents who would benefit by 2023/24.
• To continue to provide evening and weekend GP appointments in place through Extended Access Services and work together with our hospitals to integrate services where appropriate.
• To ensure all hospitals with a major A&E department have enhanced models of Same Day Emergency Care at least 12 hours a day, every day, in both medical and surgical specialties; and provide an acute frailty service for at least 70 hours a week achieving clinical frailty assessment within 30 minutes of arrival.
• To implement the findings of the Clinical Standards Review to focus on patients with the most serious illness and injury.
• To extend digital services beyond care homes to vulnerable patients in their own homes.
• To ensure appropriate approaches to self-management are considered by the Personalised Care Steering Group, which may positively impact on UEC services.

• Provide an overall better patient experience – monitored via feedback.
• Our emergency services will meet patient demand.
• Decrease our waiting times – UEC and specialities.
• All patients will receive the right care in the right place.
• We will achieve the new emergency department measures.
• Patients and the public will know what to do if they are unwell and only use emergency departments where appropriate.
• Improve patient transport.