We will offer a range of support for care and treatment which is easily accessible, from telephone advice for urgent problems to the very best hospital emergency services when the situation is life-threatening.
This will be supported by better co-ordination, for example referral through NHS 111, close working with the ambulance service, and clear information provided to patients about which services are available – and how to reach them – when they have an urgent health need.
It is not good for patients to stay in hospital for longer than they need to be there, as it can have a negative impact on their recovery and ability to maintain independence. We must therefore make sure patients in hospital beds really need to be there, and that they are not delayed when moving through the steps on their care plan.
We have been through a process to designate our three A&E departments against the national Keogh urgent care definitions. As a result of this process, we have determined that it is in the best interests of our local population to maintain the current levels of provision, namely a specialist emergency centre at Addenbrooke’s Hospital and an emergency department at Peterborough City Hospital. Hinchingbrooke Hospital will retain its A&E department and will continue to be able to manage the current caseload of minor injury and major medical cases, with a physician-led service.
Since our three hospitals are already struggling to meet existing levels of emergency demand, and our volume of planned hospital procedures is significantly above that of similar health systems, we need to improve our communitybased urgent care and our emergency services radically such that hospital is a last resort. There are several strands to this improvement work.
Ambulance services
Alternatives to hospital admission.
We are working with our ambulance teams to make sure that only patients who really need to be transferred to
hospital are taken there. We are implementing ‘hear and treat’, ‘see and treat’, and ‘see, treat, and convey’ systems which allow paramedics, supported by other medical professionals, to decide whether options other than transfer to hospital are more appropriate.
Right call, first time
Integrated urgent care and clinical hub.
From October 2016, if you call 111 and you need to speak to a clinician you will be able to do so. This service is
provided by our expanded integrated urgent care service and clinical hub. The aim is to make sure that patients receive
the most appropriate care that best meets their needs. This will ensure that our hospitals’ emergency services are reserved for serious/life threatening injuries or illnesses.
Minor injury
Walk-in minor injury services.
Following our review of the three Minor Injury Units, (MIUs), in East Cambridgeshire and Fenland, we have undertaken extensive engagement with the public, providers, and other stakeholders on a range of options for the future. Taking
this feedback into account, we have identified significant opportunities to deliver more joined-up, effective, and
efficient local urgent primary care services which reflect the rural geography, deprivation, and demography.
Whilst no formal decisions have been taken, we are now working with local stakeholders to develop the details
behind a number of options, including the development of three rural urgent primary care hubs which will focus
initially on integrating local primary, minor injury, and community services. This will move on to include development
of point of care testing and consultant support, via telemedicine links. We intend to develop and test the first phase of
any new urgent primary care model over the next 12 months, which will inform further engagement and, potentially,
consultation. We are also doing an analysis of all options put forward as part of our early engagement work.
Right call, first time for mental health concerns
Dial 111 - press 2 if you have a mental health concern.
We are embedding mental health including community crisis services, liaison psychiatry, and Suicide Prevention Strategy. We are investing £2m of urgent and emergency care funding in an evidence-based, community first response service
which provides urgent out of hours assessment and support to people in mental health crisis.
More support for people leaving hospital
We have a very high level of people staying in our hospitals for longer
than they need to be.
We believe it is not good for any patient to stay in hospital for longer than medically necessary and we are putting in
place processes to ensure that patients are discharged on time, including on-site social care staff to support discharge from hospital.
24/7 standards
In consultant-led services.
Our three urgent and emergency care hospital departments will meet the government’s seven-day service standards with early and daily consultant input to reduce the length of time people spend in hospital.