NHS Performance Statistics - January 2018

Combined Performance Summary

• Urgent and emergency care – Accident and Emergency, NHS111, Ambulances, Delayed Transfers of Care 
• Planned care – Referral to Treatment, Diagnostics, Mixed Sex Accommodation, NHS Continuing Healthcare and NHS-funded Nursing Care, Patient Reported Outcome Measures 
• Cancer - Cancer Waiting Times, Cancer Registrations, Cancer Emergency Presentations, Cancer Survival Estimates 
• Mental Health - Early Intervention in Psychosis, Out of Area Placements, Children and Young People with an Eating Disorder, Contacts and Referrals, Improving Access to Psychological Therapies

Electronic prescribing to be piloted in integrated urgent care

NHS Digital has announced trials of the electronic prescription service (EPS) in integrated urgent care settings.

This will mean that patients seeking care out of hours or in urgent care settings can have their prescriptions sent directly to a pharmacy of their choice, rather than relying on paper prescriptions.

The service will reduce the time spent by doctors and others issuing prescriptions and by pharmacists dispensing prescriptions.

Planning for seasonal demand in respiratory illness

Each winter, emergency departments experience a surge in respiratory attendances and emergency admissions for respiratory conditions double. It is therefore crucial to plan for this inevitable increase in demand so that patient flow is maintained.

A “quick guide” from NHS Improvement highlights ways to manage demand, including ambulatory emergency care, early supported discharge services, and urgent “hot” clinics. Use of these initiatives can reduce avoidable overnight admissions and improve patient flow and outcomes.

Local A&E delivery boards are advised to consider the recommendations as part of plans to manage the seasonal surge in respiratory admissions.

NHS performance statistics - December 2017

Combined Performance Summary

• Urgent and emergency care – Accident and Emergency, NHS111, Ambulances, Delayed Transfers of Care 
• Planned care – Referral to Treatment, Diagnostics, Mixed Sex Accommodation, NHS Continuing Healthcare and NHS-funded Nursing Care, Patient Reported Outcome Measures 
• Cancer - Cancer Waiting Times, Cancer Registrations, Cancer Emergency Presentations, Cancer Survival Estimates 
• Mental Health - Early Intervention in Psychosis, Out of Area Placements, Children and Young People with an Eating Disorder, Contacts and Referrals, Improving Access to Psychological Therapies

New analysis shows impact of redesigning urgent and emergency care in Northumberland

The Health Foundation has published analysis examining the early impact of changes to A&E and urgent care services in Northumberland following the opening of the country’s first bespoke emergency hospital in Cramlington in 2015.

Electronic Prescription Service (EPS) to be piloted in urgent care settings

NHS Digital and partners will shortly begin trialling use of the Electronic Prescription Service (EPS) by prescribers in urgent care settings.

A pilot will take place for selected users of the Adastra system, the clinical software used in many urgent care settings. Care settings will include NHS 111, GP out of hours services, clinical

Safe, sustainable and productive staffing in urgent and emergency care

Draft resource from NHS Improvement to help standardise safe, sustainable and productive staffing decisions in urgent and emergency care.

Transforming Urgent and Emergency Care and the Vanguard Initiative: Learning from Evaluation of the Southern Cluster

Urgent and Emergency Care (UEC) vanguards aim to improve the quality, efficiency and effectiveness of UEC services so that patients receive the most appropriate care at the right time and in the right place, and so that unnecessary admissions to accident and emergency (A&E) and hospitals are reduced. The Southern Cluster comprises three such UEC vanguards. RAND Europe's evaluation examined the impacts of the vanguards, the processes underpinning delivery (and associated enablers and challenges), and implications for future policy and practice.

The evaluation used a multi-method approach, including theories of change, document review, workshops, interviews, surveys and data dashboards. Rand's report makes recommendations concerning: (i) UEC health and care workforce capacity-building, (ii) local-national coordination around UEC transformation, (iii) collaboration across localities and professions, (iv) support for an end-to-end UEC pathway with mutually reinforcing activities, (v) cost and outcome data, (vi) an interoperable data infrastructure, and (vii) capacity for evaluation and learning.

A&E survey: Two in five report waiting more than four hours

Forty per cent of patients waiting over four hours to be seen at large A&Es, compared to 15 per cent at urgent care centres

Sixteen per cent of ambulance attendees wait over 60 minutes to be transferred to A&E

Better patient experience at type three centres compared to type one

Two-fifths of accident and emergency attendees report waiting more than four hours to be seen, a new patient survey has revealed.

To obtain this article please copy and paste the post into an email and send it to library@uhcw.nhs.uk with the subject line reading, Please obtain this article.

Safety and quality of emergency care

Chief Inspector of Hospitals Prof Ted Baker has written to England’s NHS trusts to highlight good practice from successful emergency care departments.

The examples came from discussions at a recent CQC event attended by senior clinical and nursing staff from 16 trusts rated good or outstanding for urgent and emergency care services.

The key themes identified in Prof Baker’s letter to trusts were:

• Ambulance arrivals
• First clinical assessment
• Use of inappropriate physical spaces
• Specialist referrals
• Escalation
• Deteriorating patients
• Patient outcomes
• Staff.

Service specification for integrated urgent care

NHS England has published a national service specification for integrated urgent care services. It outlines the steps that commissioners must take to deliver this important transformation and to move from an ‘assess and refer’ to a new ‘consult and complete’ model of service delivery.

Emergency eye care in hospital eye units and secondary care

New ophthalmic service guidance from the Royal; College of Ophthalmologists.  This document provides consensus guidance on good practice for urgent and emergency secondary ophthalmic care.

NHS Urgent Medicine Supply Advanced Service Pilot: Toolkit for Pharmacy Staff

A practical guide from NHS England on how to deliver the NHS Urgent Medicine Supply Advanced Service.

HSJ Value in Healthcare Awards 2017: Emergency, Urgent & Trauma Care

In November 2014 Sherwood Forest Hospitals was the second to the bottom in the ED four-hour target performance in England. The ED department had been rated as ‘inadequate’ for safety in 2015 and the trust had 17 patients breach 12 hours during December 2014 and January 2015.

The trust recognised that this was not just a problem for ED to solve and so created the Emergency Flow Programme, which is organisation wide.

‘Ultimate’ guide for pharmacists working in urgent and emergency care

The Royal Pharmaceutical Society has published what it calls the ultimate guide for pharmacists working in or with urgent and emergency care.

Number of ambulance diverts from A&E doubled this winter

Analysis finds A&E units closed to ambulances almost 500 times in just three months this winter.

Urgent response time targets only met in six out of last 49 months

The number of times hospital A&E units in England have had to close their doors to ambulances has almost doubled this winter compared with the previous three, new research from the Nuffield Trust health think-tank reveals. The authors say that the extra time paramedics are having to spend on the road as a result is a factor in the service’s inability to meet its targets for urgent requests for an ambulance.

Urgent care needs to undergo a channel shift

STPs will want to understand how they can prioritise their local investment to maximise return in terms of activity, system efficiency and the potential for financial savings that can be reinvested in services.

As part of its Urgent and Emergency Care Review, NHS England aims to connect all UEC services together so the overall system becomes more than just the sum of its parts.

The current reality is that much UEC activity is not taking place in the setting that is right for the patient and most efficient for the NHS. The interventions the UEC review has set out are intended, when taken collectively, to help shift care to the most appropriate setting.

The channel shift model is now available to be populated by local footprints using their local data, supported by a comprehensive user guide.

The channel shift model toolkit and user guide will help commissioners to plan strategically and facilitate service design. They set out 16 intervention models which include ambulatory emergency care, co-location of urgent care centres, GP extended hours, care homes falls response training and Rapid response services.

Seven day services in the NHS

New collection from NHS Improvement on seven day services in the NHS:

• What does it mean to provide seven day services?
• The 10 clinical standards
• The four priority standards
• What do seven day services mean for patients?
• Related content
• Resources

See also some shared learning case studies: 

• Implementing a central urgent advice line
• Improving access to urgent and emergency care
• Introducing seven day services to pharmacy roles (video)
• Introducing seven day services to a diagnostic team (video)
• Introducing seven day services - a transformation viewpoint (video)
• Seven day services learning and sharing event: challenges and solutions
• Providing seven day services for urgent and emergency care
• Providing 24/7 emergency care
• Introducing seven day services - a nursing viewpoint
• Introducing seven day services - a medical viewpoint
• Introducing seven day services to clinical support roles
• Introducing seven day services to therapy teams

Seven day services animated film and case studies

NHS Improvement has produced an animated film to explain what seven day hospital services are and the potential benefits to patients and staff. It explains the four priority clinical standards for urgent and emergency care which are expected to be met every day of the week.

The film is also accompanied by 17 video case studies of NHS staff, from pharmacists and porters to therapists and consultants, explaining the challenges, benefits and top tips for moving to seven day hospital services.

Safer, faster, better - transforming urgent and emergency

A guide for local health and social care communities, which details how to redesign models of care through a fundamental shift in the way urgent and emergency care services are provided.

Adopt the tried and tested principles and implement good practice in delivering urgent and emergency care.