What we are doing - urgent and emergency care

Ensuring easier access to community and GP services

We've  extend services outside A&E so that people can access local health and care when they need it – for instance, at their GP or at a local health centre. Across south east London we are extending our GP services so that bookable appointments are available 8am-8pm, seven days a week.

We are also developing more proactive services which will help prevent the health emergencies that can result in an emergency admission – like with Greta, our case study.

If residents do need emergency treatment, we want to make sure that they don’t stay in hospital any longer than they need by improving discharge planning. This means we start planning the support people need after they have left hospital as soon as possible – so it is ready and in place when they are well enough to return home.

Integrating urgent care services

We have developed a new integrated urgent care system using the free-to-call number 111. This means we will bring all the out of hours and urgent care services together, sharing standards and processes to improve the experience for patients. Central to this is the development of a Clinical Hub offering patients who require it access to a wide range of clinicians, both experienced generalists and specialists. 

  • NHS England have produced an animation showing how an integrated system could look in the future. This is a similar model to the one we are developing:

 

Standardising services

We are working to make the system less confusing by standardising services. At the moment we have a variety of urgent and emergency care facilities, including walk-in centres and minor injuries units. It can be confusing knowing where to go and what services are available at the different centres – for instance, x-rays for broken bones or blood tests for other conditions. We want to simplify the system and help residents understand what is available so that they can choose the most appropriate service for their condition.

For information about getting the right care: https://www.nhs.uk/using-the-nhs/nhs-services/urgent-and-emergency-care/

Consistency of care

The experience people have when they attend A&E or urgent care centres can also vary depending on which site in south east London they visit. Clinicians and managers from our emergency departments are working together to introduce of a consistent front door streaming process during 2017. Front door streaming is carried out by a trained nurse or clinician before registration, with an assessment of the patient to decide whether they need to be seen in the Emergency Department or at an Urgent Care Centre.

We are increasing access to specialists in A&E including access to frailty, paediatrics and mental health experts.

We want to ensure that every A&E has short stay paediatric units and rapid response teams to help children stay out of hospital.

 

Mental health in A&E

We want access to crisis mental health services to be easier and faster. We are working to meet the national CORE24 standards which set out the requirements for adult mental liaison health services.