Background to consultation

click here to read our consultation document

Introduction
Urgent Care Review
Why things need to change
Our vision for urgent care
Developing our options for consultation
Evaluation of scenarios
Outcome of consultation
 

Thank you for taking the time to learn about urgent care services in the East Riding of Yorkshire. The information on this website has been provided so that you can understand the background to our plans for the future of urgent care services which we have recently consulted on.

We believe that change will create a better, joined up Urgent Care system for everyone.

Like many NHS organisations up and down the country, we are working hard to transform services so that they are better for patients, deliver the right care, in the right place, first time and improve value for money.  This is a difficult balancing act, especially in a large area such as the East Riding of Yorkshire where many people’s homes are spread across the countryside and in small villages.

Local urgent care and community staff do an amazing job but because the system is not working as well as we would like it to, we often struggle to recruit and retain staff with the right skills who are able to work across our large area.

Urgent Care Review
We have been working with a range of clinicians, partner organisations, and patient representatives to consider and develop local ideas to improve the urgent care system. As a result of this work, we created an Urgent Care Strategy that aims to improve urgent care services for everyone in the East Riding.  

Some of the suggested improvements in our Urgent Care Strategy mean significant change needs to happen and we have made some important decisions. Everybody cares about the NHS because we all benefit from NHS care and treatment throughout our lives. This is why we have listened to you during our three month public consultation.

Implementing our Urgent Care Strategy involves the review and re-design of a wide range of urgent care services including:

• Ambulance services
• Accident & Emergency Departments
• NHS 111 (single point of contact)
• GP out-of-hours
• Community services that support urgent needs
• Urgent Care Centres (community and primary care facilities providing access to urgent care for a local population including walk-in centres, minor injuries units, GP-led health centres and all other similar facilities)
• Social care
• Community beds

Locally, we have made some important decisions in relation to introducing urgent care centres and improving wrap around patient care.  We believe that our plans will improve local urgent care services, but they do mean changes to the way services are currently offered and accessed.

Why things need to change
Our patients tell us they are often confused about where they should go for their treatment. Dialling 999 or going straight to Accident and Emergency (A&E) departments is usually the norm. In some cases, patients will be passed around the system until they end up in A&E anyway or are admitted to hospital (sometimes after a long wait in A&E) when this could have been avoided if the system was simpler to understand.

Some services are duplicated or significantly underused whilst others are constantly coming under more and more pressure. Much of our money is tied up in paying for beds and buildings that are not always well used. Our proposals mean that we could invest more money where it is needed.

Our vision...
Patients receive treatment in centres with the right facilities and expertise whilst also assuring that individuals can have their urgent care needs met by services as close to home as possible whilst providing a safe, sustainable and affordable service.

In a nutshell this means...
Patients always receive the right care in the right place with the best outcome, first time. 

Developing our options for consultation 
To support the development of proposals for service change we conducted a rigorous options appraisal process which included the following steps:

• Development of a long list of scenarios for consideration (81 for Urgent Care Centres and 70 for community beds).
• Agreeing the appraisal criteria used to assess scenarios.
• Agreeing the weighting to be applied to the criteria.
• Establishing shortlists of scenarios from the long lists utilising the criteria and weighting (stakeholders, clinicians and CCG representatives were asked to develop individual weighting scores for the criteria which were used to score the scenarios).
• Applying the criteria to the shortlists to establish a list of highest ranking scenarios.
• Costing the highest ranking scenarios to identify a shortlist of potential options for consultation.

All these steps included stakeholder and clinical engagement throughout the process and approval by the CCG Governing Body. 

Evaluation of scenarios
In order to understand the implications for improved health and wellbeing of the population, we used available evidence, and assessed the impact of scenarios in order to evaluate every scenario on the long list.  Scenarios were evaluated on the basis of their ability to:

• Have a positive impact on improved health and wellbeing of the population.
• Improve patient experience and access to services.
• Meet or improve upon all clinical and quality standards.
• Be suitable for implementation during April 2017 - March 2018.

A decision had been agreed in advance only to cost the top 6 highest scoring scenarios.  For Urgent Care Centres, 9 scenarios were costed due to minor differences in the top 6 highest scoring scenarios from stakeholders, clinicians and CCG representatives. The scenarios which met the fifth and final test (regarding affordability) progressed to consultation on the basis of value for money.

Outcome of Consultation
The consultation has now closed but you can find out what people said by visiting our Feedback Analysis Page.

Details of the decisions that have been made can be found here.