New 'vanguard' areas to link GP out-of-hours with other urgent and emergency care

The first eight urgent and emergency care vanguards have been announced by NHS England to spearhead new integrated models of delivery.

Simon Stevens: urgent care overhaul (Photo: Pete Hill)
Simon Stevens: urgent care overhaul (Photo: Pete Hill)

NHS England said the new systems would launch the transformation of urgent and emergency care for more than 9m people.

The new models will see care delivered by GPs, pharmacists, community teams, ambulance services, NHS 111, and social care.

Six of the programmes will cover smaller areas including GP practices and social care, with two larger network vanguards integrating across larger populations.

GP out-of-hours care

NHS England chief executive Simon Stevens said: ‘Starting today, the NHS will begin joining up the often confusing array of A&E, GP out-of-hours, minor injuries clinics, ambulance services and 111 so that patients know where they can get urgent help easily and effortlessly, seven days a week. That’s why we’re backing what our frontline nurses, doctors and other staff, in partnership with local communities, to radically redesign our urgent and emergency services.’

The announcement is the latest implementation of the urgent care review led by NHS England’s medical director professor Sir Bruce Keogh and the NHS in England’s Five Year Forward View plan to reshape care delivery.

In March, 29 new care model vanguards were announced including GP-centred multispecialty community providers (MCPs) and vertically integrated primary and acute systems (PACS).

Earlier this month NHS England asked local commissioners to halt all procurements for NHS111 and GP out-of-hours contracts while it draws up a new integrated model specification, a move welcomed by GP leaders. 

Like the previous vanguards the urgent care systems will have access to a programme of support and investment from a £200m transformation fund.

NHS England’s director of acute care Professor Keith Willett said: ‘All over the country there are pockets of best practice yielding enormous benefits; but to ensure our urgent care services are sustainable for the future every region must begin delivering faster, better and safer care. Now it is time for the new urgent and emergency care vanguards to design the best solutions locally.’

The urgent care vanguards:

South Nottingham System Resilience Group: Made up of more than a dozen local partners including GP-led 111 provider Derbyshire Health United Ltd and GP out-of-hours provider Nottingham Emergency Services as well as hospital and ambulance trusts.

Cambridgeshire and Peterborough CCG: ‘The CCG’s vision is to create an overarching super system resilience group with strong clinical leaders, as part of the existing network.’

North East Urgent Care Network: ‘This programme will enable the network to transform the regional UEC system and its services to further improve consistency and clinical standards, reduce fragmentation and deliver high quality and responsive health and social care to patients.’

Barking and Dagenham, Havering and Redbridge System Resilience Group: ‘Aims to create a simplified, streamlined urgent care system delivering intelligent, responsive urgent care for 750,000 residents in the most challenged health economy in the country.'

West Yorkshire Urgent Emergency Care Network: ‘Yorkshire Ambulance Service will develop a stronger focus on becoming a mobile treatment service delivering care at patients’ homes.

‘Mental health service providers will work with West Yorkshire Police to deliver major service change which will see rapid crisis response through emergency response control centres and "street triage".’

Leicester, Leicestershire & Rutland System Resilience Group: ‘Will bring together ambulance, NHS111, out-of-hours and single point of access services to ensure that patients get the right care, first time.

‘The network will include a same-day response team with GPs, acute home-visiting and crisis response services, community nursing, older peoples’ assessment unit and urgent care centres.’

‘In 2016, the hospital’s urgent and emergency care front door will be re-launched to include an assessment team with the ability to refer patients to ambulatory clinics, assessment beds, on-the-spot urgent care centres or primary or community care.’

Solihull Together for Better Lives: ‘Will involve building an urgent care centre within the hospital site capable of delivering a minor illness and minor injury service in line with the description of urgent care centres given within the Keogh report, which includes GP out-of-hours, urgent primary care and minor injury services.’

South Devon and Torbay System Resilience Group: ‘The vanguard will develop new urgent care centre facilities at pace in at least two areas, prioritising those of higher deprivation to reduce inequalities.

‘To make the best use of the resources spent locally on urgent and emergency care and avoid duplication, primary care facilities will be co-located with A&E and urgent care centres in at least two locations, and primary care records will be shared with the out-of-hours provider.’

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