Since the Clinical Commissioning Groups (CCGs) in Birmingham and Solihull took ownership of urgent care commissioning last autumn, we have been working with providers to explore new ways to streamline care for the benefit of patients. We need to have the right configuration and capacity within the service so that patients reach the right service, first time.
Acute Medical Clinics at Heart of England NHS Foundation Trust
We have recently established an Ambulatory Emergency Care (AEC) service at Heartlands Hospital and Good Hope Hospital. The AEC model is similar to the Acute Medical Clinics, which were introduced at the Queen Elizabeth Hospital in September 2011. AEC clinics run Monday to Friday and treat patients with complicated health problems, who have initially been seen in the A&E department or referred from their GP and who would otherwise have been admitted for a short stay in hospital.
Patients have all necessary tests done and are then seen by a consultant, resulting in nearly 80% of people seen in the AEC clinics going home the same day with a diagnosis and appropriate treatment rather than having to stay in hospital. The clinics also increase the number of beds available for those patients who really need them and improve the flow through the A&E department. AEC clinics will be established on the Solihull site by 25 October.
Urgent Care/Walk-in Centres
We are developing a standardised specification for all Birmingham and Solihull Walk-in Centres to link a consistent service offer to other developments in urgent care. These include NHS111 and the development of a primary carefront door to A&E, where we are exploring a new model with an Urgent Care Centre colocated with the A&E Depaertment. Patients will be directed by a primary care clinician to an Urgent Care Centre or an A&E, depending on their condition, so that they would be seen by a doctor or nurse as quickly as possible.
It is essential that we work closely with GPs to understand the levels of demand they are experiencing; so that we can look at ways to improve urgent care access in surgeries and support GPs by exploring new ways to manage demand in primary care. As part of this, we are carrying out a full audit of our capacity in primary care across Birmingham. The work is being carried out in two parts, with the first part due to be completed towards the end of this year.
Working with West Midlands Ambulance Service
In response to the increasing demand being placed on the ambulance service we are working to continue to increase the number of patients who are provided with telephone advice or treated at the scene rather than being taken to an A&E department. We are also working to ensure that ambulances are not delayed at A&E departments by improving processes for the clinical handover of patients.
Dealing with seasonal pressures
Using the lessons learned from this winter we have developed a surge plan for Birmingham and Solihull to deal with peaks in demand, working with West Midlands Ambulance Service and acute, social care and community service providers.
We are keen to share information about our plans to develop urgent care for the future and we welcome opportunities to discuss how improvements can be made for the benefit of patients. We have attended a number of events in Birmingham and Solihull over the past few weeks, including Birmingham’s Overview and Scrutiny Committee and our CrossCity Voice event.
We are continuing to engage with patient groups, GPs, healthcare providers, community services, Health and Wellbeing Boards, MPs, councillors and many other interested groups in Birmingham and Solihull to find out their views on urgent care.
NHS111 is fully operational on a 24-hour basis in Birmingham, Solihull and the Black Country and the short term arrangements that were put into place to cover the out of hours service for the switch-on are working effectively.
The service has been performing well across Birmingham and Solihull, and the latest data indicates that there have been no significant increases in attendances at A&E or the number of ambulances sent out. In addition to this, recent statistics show that calls are being answered within the required timeframe.
This is all good news and confirms that we have a robust and safe 111 service for our patients and public.