Case study - primary care - out of hours services

Customer

Bedfordshire Heartlands & Luton PCT

Challenge

To provide out of hours urgent care services for over 450,000 patients.

Result

Care UK is the only IS provider to successfully run a UCC integrated into A & E providing treatment to sub major level.
Having welcomed the first patient within 10 minutes of signing the interim contract the UCC service now see’s approximately 3,000 patients per month with a reduction in Trust activity in the out of hours period by an average of 33%. This has delivered savings of approximately £359k.

We are exceeding patient’s and commissioner expectations whilst saving the NHS vital finances.

The client

Bedfordshire Heartlands PCT is a self governing NHS organisation; it is responsible for improving the health and health services for around 250,000 people living in its area.
Luton PCT serves a population of just under 200,000. One of the main challenges for these PCTs is the predicted rapid increase in its population, which is taking place as a result of the existing county structure plans, and the additional house building programme described in the Milton Keynes and South Midlands sub regional strategy.

The need

Heartland and Luton PCTs worked together to commission a new integrated urgent care service across the two PCTs. The PCTs needed to commission 5 elements of the urgent care service from October 2006. The services were for out of hours provision 6.30 -8.00am Mon to Friday and 24/7 Saturdays, Sundays and all Bank Holidays.
The PCT had a vision that anyone who perceives they have an urgent care need will be assessed and treated in the right place at the right time to meet their individual need. People should be supported as close to home as cost effectively and safely as possible.
In order to achieve this vision all services providing rapid access or urgent/emergency care will have to work together in an integrated whole system. This partnership approach is key to making integrated urgent care services work effectively for patients.
Six key objectives had been identified by the South Bedfordshire and Luton Emergency Care Network to be achieved in the term of the contract. These objectives were:

1) To ensure a whole system approach to;

• Commissioning
• Delivery
• Audit, evaluation and performance management
• Change Management

2) To ensure consistent assessment is in place across all urgent care services, leading to consistent and appropriate care wherever and however the patient presents by the end of the first year of contract.

3) To reduce occupied bed days by 15% by the end of the 2nd year.

4) To ensure appropriate pathways and processes are in place. To enable people to be cared for in the right place at the right time by end of the first year of the contract.

5) To ensure self-care advice is provided wherever possible and appropriate by end of the first year

6) To ensure integrated/shared infrastructure is in place across all urgent care providers. This includes integrated IT and workforce design, training and education by end of the first year of contract

The solution

Care UK’s approach met the requirements for the Unscheduled Care service to Luton and Bedfordshire Heartlands Primary Care Trust by offering innovative clinical and physical solutions, designed to be attractive to NHS patients and their advocates. The Care UK scheme attracts patients by offering efficient and patient centred healthcare services from PCT identified facilities conveniently located for the major centres of population throughout the project region of Luton and Bedfordshire.

Our proposal for integration ensured that the service solution fitted seamlessly with the local health economy. We recognised the importance of gaining the confidence of acute care specialists and consulted with all stakeholders before finalising our protocols and care pathways.

Care UK’s operational proposal is based on a robust IT solution (ADASTRA v3) that will be crucial to manage the projected levels of patient contact. The solution uses an existing Patient Management Centre infrastructure that currently successfully manages in excess of 80,000 patient contacts per annum which is NpfIT compliant.

In our solution, our offering provided a full service including Patient Contact, Clinical Triage, PCC by appointment, UCC walk in, Home visiting, and patient transport where needed.

The solution is based on a full local service from a fully staffed and equipped local contact centre with two Primary care centres at Leighton Buzzard and Luton. In addition to this is a fully staffed Urgent Care Centre operation, open initially during the OOHs period but then for 24/7.