ANALYTICAL APPROACH TO SUPPORT THE URGENT CARE AGENDA

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ANALYTICAL APPROACHTO SUPPORT
THE URGENT CARE
AGENDA
Joe Clancy - Change Innovation Manager - NHSL -
16 December 2008 - V2
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2007/08 - Drivers in NHSL

• Emergency Response Centre (ERC)
• Will establish closer working arrangements
  between the Scottish Ambulance Service, NHS 24,
  Out of Hours services and NHS Lanarkshire to
  provide a more integrated emergency service
• Get the patient to the right place first time
• Multi agency
• Referenced in BHBC

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More about the ERC

• Pilot Project for emergency GP referrals
• Developed in 2007 and 2008
• Implemented in November 2008
• Monitor and evaluate over 2 /3 years
• Establish evaluation baselines
• Multi agency evaluation criteria and performance
  indicators

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Work in NHSL over the last year

• Service demand review - SAS/NHS24/OOH
• SAS emergency call review
• Review of inter hospital transfers (IHT) by SAS
• Review of trends in emergency admissions
• Emergency care workforce planning - AE activity
  review

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What we have learned

• Is hospital based info fit for purpose?
• e.g. referral source type and recording
• e.g. diagnosis and outcome
• Multi agency systems tell us different things
  (but fit for own purpose)
• No direct linkages across the systems
• Multi agency systems do not always reconcile
• Gaps in the information that is required
• e.g. routine recording of GP emergency referral
  phone contact

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What we need to do high level

• Need to understand before we act
• How choice is made which queue to join
• Steps in and out of the emergency pathway
• Outcomes
• Suggestion - first steps to do this ..
• Produce a composite matrix of what information is
  available to each agency
• Comprehensively link patient flow data across
  individual agency systems use proxy measures
  where necessary
• Beneficial to link datasets at national level

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NHSL High Level Demand Matrix
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Some Current NHSL Work

• Catchment Management Perspective - GP Practice
  Level
• Who goes where and why?
• Opportunities for re-aligning emergency flows
• to alleviate pressures
• Using Building Blocks
• e.g. 98 practices, 9/10 localities, 2 CHPs, 3
  acute hospitals, 12 SAS stations
• Compare standardised attendance admission rates
• Benchmark nationally
• Utilise NAVIGATOR
• Emergency admission and bed day rates

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Annual Demand in NHSL

• Contacts with NHS24/OOH - C 130,000
• SAS emergency incidents - 65,000
• AE attendees - 190,000
• Acute emergency admissions - 55,000

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NHSL Recent AE Trends - 1
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NHSL Recent AE Trends - 2
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NHSL Recent AE Trends - 3
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NHSL - SAS IHT Trends