Challenge 
The health system was struggling to manage a high number of attendances in A&E and urgent care plus increasing non-elective admissions to hospital and developed an integrated urgent care pathway.
 
Our work 
We designed and developed an integrated solution to deliver the pathway including a urgent care centre, a network of GP led Health Centres and the out of hours services. The project approach involved extensive provider and GP engagement. GP practices were a challenging and less engaged stakeholder. In winning the primary stakeholder’s trust and confidence, I we created a locality-wide federation, in order to influence the healthcare commissioning intentions within the region, forming a new model of out of hours care. We developed the service specification for a new model of out of hours care in order to meet the demands of the service during the busiest periods of the year.

Outcome
–       A feasibility study for meeting the patient demands for an Out of Hours Service in the area was undertaken.

–       The development of the service specification based on capacity modelling by the and testing the idea of Urgent & Emergency Care hubs in primary care and how this will impact the system in shifting emergency department attendances, reducing avoidable emergency attendances and easing the pressure on emergency services was tested.

–       The pilot tested the success rate of the out of hours care model in terms of technical, economic and operational feasibility, which proved to be a success.

–       The re-design was successfully rolled out and continues to be delivered with the support of the local GPs.