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Commissioning and the ED. Dominic Williamson EM Consultant RUH Bath. Background. DGH 70,000 patients per year ‘High acuity’ High occupancy Long trolley waits Poorly performing. ED problem Trust problem Health community problem Urgent Care Network. UCN.

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Commissioning and the ed

Commissioning and the ED

Dominic Williamson

EM Consultant

RUH Bath


Background
Background

  • DGH 70,000 patients per year

  • ‘High acuity’

  • High occupancy

  • Long trolley waits

  • Poorly performing


  • ED problem

  • Trust problem

  • Health community problem

    • Urgent Care Network


UCN

  • Face to face contact with providers and commissioners

  • Chaired by PCT

  • What we’ve done….

    …. what can we do

  • Pilots galore


IST

  • Improved discharges/access to care

  • Improved response in escalation

  • More co-ordinated community response

  • Collocation of GP OOHs

  • Nursing home LES

  • Front door streaming


Stagnation
Stagnation

  • Treading water past 18 months

    • No new projects

    • Recoiling from integration

    • Increasing isolation

  • Getting to know you


New dawn ccg
New dawn CCG

  • Effective change

    or ‘shall we just carry on for now’

  • Local GPs

  • Easy access

  • Making the right noises



Support
Support

  • Co-location of walk in service

  • Co-ordination of MIU services

  • Move to assessment service

  • Unified GP response

  • Improved EoL planning and care

  • Improved information sharing


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