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Joe Clancy - Change & Innovation Manager - NHSL - 16 December 2008 - V2

ANALYTICAL APPROACH TO SUPPORT THE URGENT CARE AGENDA. Joe Clancy - Change & Innovation Manager - NHSL - 16 December 2008 - V2. 2007/08 - Drivers in NHSL. Emergency Response Centre (ERC)

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Joe Clancy - Change & Innovation Manager - NHSL - 16 December 2008 - V2

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  1. ANALYTICAL APPROACHTO SUPPORT THE URGENT CARE AGENDA Joe Clancy - Change & Innovation Manager - NHSL - 16 December 2008 - V2

  2. 2007/08 - Drivers in NHSL Emergency Response Centre (ERC) • Will establish closer working arrangements between the Scottish Ambulance Service, NHS 24, Out of Hours services and NHS Lanarkshire to provide a more integrated emergency service • Get the patient to the right place first time • Multi agency • Referenced in BHBC

  3. More about the ERC • Pilot Project for emergency GP referrals • Developed in 2007 and 2008 • Implemented in November 2008 • Monitor and evaluate over 2 /3 years • Establish evaluation baselines • Multi agency evaluation criteria and performance indicators

  4. Work in NHSL over the last year • Service demand review - SAS/NHS24/OOH • SAS emergency call review • Review of inter hospital transfers (IHT) by SAS • Review of trends in emergency admissions • Emergency care workforce planning - A&E activity review

  5. What we have learned • Is hospital based info fit for purpose? • e.g. referral source type and recording • e.g. diagnosis and outcome • Multi agency systems tell us different things (but fit for own purpose) • No direct linkages across the systems • Multi agency systems do not always reconcile • Gaps in the information that is required • e.g. routine recording of GP emergency referral phone contact

  6. What we need to do – high level Need to understand before we act • How choice is made – which queue to join • Steps in and out of the emergency pathway • Outcomes Suggestion - first steps to do this …….. • Produce a composite matrix of what information is available to each agency • Comprehensively link patient flow data across individual agency systems – use proxy measures where necessary • Beneficial to link datasets at national level

  7. NHSL High Level Demand Matrix

  8. Some Current NHSL Work Catchment Management Perspective - GP Practice Level Who goes where and why? • Opportunities for re-aligning emergency flows • to alleviate pressures • Using Building Blocks • e.g. 98 practices, 9/10 localities, 2 CHPs, 3 acute hospitals, 12 SAS stations • Compare standardised attendance & admission rates • Benchmark nationally • Utilise NAVIGATOR • Emergency admission and bed day rates

  9. Annual Demand in NHSL • Contacts with NHS24/OOH - C 130,000 • SAS emergency incidents - 65,000 • A&E attendees - 190,000 • Acute emergency admissions - 55,000

  10. NHSL Recent A&E Trends - 1

  11. NHSL Recent A&E Trends - 2

  12. NHSL Recent A&E Trends - 3

  13. NHSL - SAS IHT Trends

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