NHS to adopt new urgent care models where health service is struggling

New urgent care models could be developed in areas where health services are under pressure, NHS England's chief executive has suggested.

Simon Stevens: urgent care reforms planned (Photo: Alex Deverill)
Simon Stevens: urgent care reforms planned (Photo: Alex Deverill)

The current system of urgent, emergency and GP out-of-hours services is too confusing for patients, Simon Stevens said. A 'vanguard' approach, similar to the programme used to develop new models of integrated primary and hospital care, will be used to roll out new models, he confirmed.

The Five Year Forward View published by NHS England last year set out a range of new models of care to be developed.

Twenty-nine vanguard projects, most of them integrating general practice with secondary or community care services, were launched in March.

GP access plans

The Five Year Forward View said urgent and emergency care networks would be developed to ensure patients have access to the right care at the right time, making better use of primary care through evening and weekend access to GPs.

Addressing a King’s Fund event in central London Mr Stevens said: ‘We saw once again over this winter that the existing siloed front-end of the NHS, be it 111, GP out-of-hours, the 999 service, urgent care centres, A&Es, is pretty confusing.

‘So we are going to take a place-based vanguard-type approach to urgent and emergency care redesign. As we do that, looking at better metrics for measuring the success of emergency care.’

But, he suggested, the development of the new models could be more tightly controlled than the previous vanguard process because of the instability facing services in some areas.

New models of care

‘Some of the parts of the country that will go down this path will be places that it is pretty clear their systems are in disequilibrium right now’, said Mr Stevens, ‘so there are probably going to be tighter guardrails around what the development path is going to look like than in some of the others’.

Meanwhile, last month NHS England told local commissioners they must ensure no patient has to attend A&E because they were unable to get a GP appointment.

The demand was one of eight short-term priorities to be included in local operational plans, in a letter from NHS England’s director operations and delivery Sarah Pinto-Duschinsky and director of acute care, professor Keith Willett to CCGs and local system resilience groups.

CCGs and SRGs were told to use 2015/16 to ‘focus on implementing transformational changes to their local urgent and emergency care services’ as outlined in the Urgent and Emergency Care Review.

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