Agenda item

Kath-Wynne Jones, Chief Executive Locality Care Alliance will report at the meeting.  Report will be sent to follow.

Kath Wynne-Jones - Chief Executive LCA presented a report updating Members on the work being undertaken in relation to Urgent Care.

The transformation of Urgent Care is a key programme within the Locality Plan for Bury.

The LCA Chief Executive reported that the challenges in Bury echo that in most other health systems with rising demand for urgent care services, increasing numbers of 999 calls, A&E attendances and non-elective admissions. The urgent care system has multiple entry points and it can be confusing to patients with a tendency to default to A&E.

Bury Locality Care Alliance providers have been working with commissioners to develop a more integrated urgent care system for Bury.

This is a long term programme but three projects were identified as priorities:

1)   A paramedic Green Car – NWAS is the provider and the aim of the Green Car is to provide an expanded local see, treat and connect response to lower acuity 999 calls. The service operates 7 days a week 12 hours a day.

2)   An Integrated Virtual Clinical Hub [IVCH] – to provide local telephone based clinical assessment and where required direct booked access to GP and OOH appointments. The provider is BARDOC and the service operates 7 days a week during the out of hour’s period.

3)   An Urgent Treatment Centre at Fairfield General Hospital.  The UTC operates as a minor injury and illness unit and is a partnership between Northern Care Alliance, BARDOC and Bury GP Federation. It operates 7 days a week, 12 hours a day – 08.00 – 20.00.

The Phase 1 pilot of the UTC opened on 5 November 2018. It is open 08.00 – 20.00 seven days a week and is staffed by a GP, Advanced Nurse Practitioner and Emergency Nurse Practitioner. All patients who attend the FGH A&E department are clinically assessed and those with a minor injury or illness are streamed to the UTC. Up to 60 patients a day have been seen and treated in the UTC. This has eased the pressures over winter within the ED for this cohort of patients.

Those present were invited to ask questions and the following issues were raised.

Responding to a Member’s question the LCA Chief Officer reported that it was initially envisaged that it would take the UTC 6 months to be fully operational however this took effect after only 6 weeks. 

With regards to readmission rates following a green car visit, the LCA Chief Officer reported that she did not have this information to hand but could circulate this information following the meeting.

Members discussed the out of hospital offer.  The LCA are in the process of developing a new offer, one which it is hoped will operate without organisational boundaries.  This will include integrated neighbourhood teams, intermediate services, rapid response teams and end of life services.

Responding to a question with regards to whether the new urgent care schemes will generate savings and efficiency’s; the LCA Chief Officer reported that the demographic changes as a result of an ageing population as well as rising levels of acuity, mean it is difficult at this current time to take money out of the Acute system whilst the demand continues to grow.  Money will be invested in community services via GM Transformation funding.  There is a strong evidence base that by investing in intermediate services this will lead to a shift in demand, away from the Acute sector.  The same evidence base does not currently exist for investment in the Integrated Virtual Clinical Hubs– wider work will need to be undertaken which will including building resilience in the system.

        It was agreed:

        The LCA Chief Officer be thanked for her attendance.