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  1. Jarrow NDUC – North Scotswood NDUC - Tees Eston Grange Vocare North East Locations

  2. North East Operations Centres

  3. Northern Doctors Urgent Care North East Ambulance Service • North East NHS 111 Service

  4. North East NHS 111

  5. 1996 800 2.3 million £23 million Vocare Group Facts

  6. Northern Doctors Urgent Care

  7. GP Led 7 GPs in Senior Clinical Management Team 24/7 Clinical on Call Integrated Group Clinical Review

  8. Tees March 2013 NQR Performance

  9. Audit NHS Tees A&E Audit carried out by Dr Peter Haywood NHS Tees NDUC A&E/999 Audit carried out by Dr Edward Summers NDUC Period 10 June 2013 to 17 June 2013

  10. Outcomes – A&E NDUC 2857 Total A&E Attendances 922 NDUC Cases 25 NDUC A&E/999 referrals to A&E Non NDUC 2.71% of NDUC Cases 0.88% of A&E Attendances

  11. Outcomes – Admissions (not A&E) 7.5% of NDUC cases this week 5.4% of NDUC cases July 2013

  12. Total Secondary Referrals (Admissions + A&E/999) NDUC 10% (NDUC Internal) National 12-16% (Primary Care Foundation Report of April 2012)

  13. 999 Cases • complicated distressed acute retention of urine following cystoscopy that day • lab result indicating a heart attack • cardiac chest pain with history of previous heart attack • ?stroke • cardiac chest pain and difficulty in breathing • significant overdose of painkillers

  14. A+E Cases • 3 arranged after face to face assessments – 92yo fall, 93yo fall, 11yo wrist injury after discussion with A&E Consultant • 3 sent to A&E after discussion with district nurses regarding patients with catheter problems • 2 patients elected to attend A&E despite offer of centre appointment • 1 patient sent to A&E after discussion with Gynaecology on call

  15. A+E Cases • 1 patient called ambulance prior to NDUC Dr telephone assessment • 1 patient assessed at 2300hrs with eye symptoms – referred to Eye Casualty Clinic the next morning • 6yo with needle stick injury from syringe on allotment • 32yo with malaena (significant stomach bleeding) • Severe abdominal pain with pain score 10/10

  16. A+E Cases • abdominal pain • incarcerated hernia • 12m baby vomiting x40 over 34hrs • Suspect ectopic pregnancy/miscarriage • Unwell infant • ?Croup

  17. Total Secondary Referrals (Admissions + A&E/999) NDUC 10% (NDUC Internal) National 12-16% (Primary Care Foundation Report of April 2012)

  18. 2012/13

  19. 2012/13

  20. Moving Forward • • Paramedic Support • • Special Patient Notes • • Access to GP Patient Records • CREAM • (Clinical Review Evaluation and Assessment Meetings) • SERRG • (SEcondary Referral Review Group)

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