January 2012 - UNISON South West

NHS 111 implementation in the South West

January 2012

What is NHS 111? 

A new national NHS telephone advice line and signposting service For patients with urgent health problems which require assessment but are not so serious as to require 999 Free to call number 24/7 to respond to people’s healthcare needs when:

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they need medical help fast, but do not believe it is a 999 emergency they do not know who to call for medical help, for example they do not have a GP to call or are away from home they think they need to go to A&E or another NHS urgent care service they require health information, signposting, or reassurance about what to do next

There will be three options to call: 999 – 111 – or GP practice during daytime

Why do we need it?  Nationally:  People are confused by what is available and too often use a service which is not the best one to meet their needs  Research in 2009: – 38% were not sure of care options available for less serious conditions outside GP hours – 50% were more likely to use A&E on an evening/weekend to access NHS help – Variation in quality between different types of service and different areas of the country

 In the South West:  The Next Stage Review in 2008/9 found that people were unclear about the options available to deal with an urgent care need and did not know which number to call  The Strategic Framework for Health in the South West identified a need to streamline access to urgent care to help route patients to the most appropriate service first time

The current picture

Government commitment 2010

‘The government will […] Develop a coherent 24/7 urgent care service in every area of England that makes sense to patients when they have to make choices about their care. This will incorporate GP out-of-hours services and provide urgent medical care for people registered with a GP elsewhere. We will make care more accessible by introducing, informed by evaluation, a single telephone number for every kind of urgent and social care and by using technology to help people communicate with their clinicians.

White Paper Equity and excellence: Liberating the NHS, July 2010

NHS 111 - national implementation  

NHS 111 is a national programme Four national pilot sites set up in 2010:    

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County Durham and Darlington (North East) Nottingham City (East Midlands) Lincolnshire (East of England) Luton (East of England)

Department of Health & Secretary of State commitment to implementation in all localities by April 2013

NHS 111 - aims  

The aim is to simplify access to the urgent care system Specifically by:    

improving public access to urgent healthcare helping people use the right service first time, including selfcare providing management information on usage of services to commissioners enabling and supporting quality and productivity plans for urgent care

NHS 111 - core principles  

The minimum requirements are set out in a national specification NHS 111 service must be able, 24/7, to:  dispatch an ambulance without delay  complete a clinical assessment on the first call without the need for call back  refer calls to other providers without re-triage  transfer clinical assessment information to other providers  book appointments where appropriate  signpost to another service, where outside the scope of 111  conform to national quality and clinical governance standards

What will NHS 111 look like? ACCESS NHS 111 call advisers Locally commissioned call handling

ANSWER

Clinical Assessment Consistent assessment of clinical needs

ASSESSMENT

APPROPRIATE CARE

Directory of local skills and services Provided by each NHS organisation in a PCT area, including opening hours, referral criteria, and real- time capacity

999 Midwife

A&E

MIU Pharmacy

GP in hrs

GP OOH

NHS Direct

WiC

DN

Other services

Commissioner configuration in the South West  

20 shadow Clinical Commissioning Groups Seven Primary Care Trust clusters:       

NHS Bath & North East Somerset and NHS Wiltshire NHS Bristol, North Somerset, South Gloucestershire NHS Somerset NHS Gloucestershire and NHS Swindon NHS Dorset and NHS Bournemouth & Poole NHS Devon, Plymouth and Torbay NHS Cornwall

Planning for NHS 111 in the South West 

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NHS 111 services will be managed on a Primary Care Trust cluster basis Primary Care Trust clusters are working with Clinical Commissioning Groups and providers to:  specify the requirements for the local service  develop a comprehensive Directory of Service which will inform the choice of service people have when they call 111  develop robust clinical governance arrangements Co-ordinated procurement across the South West with locally defined lots based on PCT cluster areas

Some facts and figures 

Current call volumes in South West:   

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~750k 999 calls ~450k NHS Direct calls ~1.1m Out of Hours calls

Populations (5.3m for South West): Primary Care Trust

Population

NHS Bristol North Somerset and South Gloucestershire

925,507

NHS Gloucestershire and Swindon

792,900

NHS Bath and North East Somerset and Wiltshire

643,030

NHS Devon, Plymouth and Torbay

1,138,100

NHS Bournemouth and Poole and Dorset

710,200

NHS Somerset

538,494

NHS Cornwall and Isles of Scilly

533,300

Timeline  Advert published

September 2011

 Pre-Qualification Questionnaire

November 2011

 Invitation to Tender

January 2012

 Contract award

June 2012

 Mobilisation period

June 2012 – Jan 2013

 Phased implementation

Jan – March 2013