Getting the Right Care in the Right Place

Evaluating the introduction of the Redesign of Urgent Care

Patients using a new service to direct people to the right urgent care service had a mostly positive experience, a new report has found.

An evaluation of the Redesign of Urgent Care, which was launched in December 2020, found that people given appointments at A&E or minor injuries via NHS 24 111 reported shorter waits than those who visited A&E without an appointment.

The report also found an increased use of NHS 24 111 service during weekday in-hours, reduced unplanned attendances to Emergency Departments and fewer ambulance callouts and trips to hospital, noting there are several factors that may have contributed to these changes.

The report recommends, supporting NHS 24 to reduce call waiting times calls, improving the availability and capacity of alternative services available via flow navigation centres– which direct people to the most appropriate service for their health and care needs-  and continuing to provide public messaging on when to call 111. 

The Scottish Government is working with boards to drive improvements in how health care services are accessed.

Health Secretary Neil Gray said: “I welcome this report which gives us some valuable insight into how we can improve the way the health service manages demand for urgent care services.

“We know there is still work to do, but it is encouraging that this evaluation found patient experience of the Redesign of Urgent Care was largely positive, and that people given appointments experienced shorter waits. I thank all the staff involved in this important piece of work.

“Work is already underway to implement the recommendations of this report, including increasing staff numbers at NHS 24. This winter there are a record number of NHS 24 call handlers available to direct people to the most appropriate care, helping reduce unnecessary A&E attendances.

“Our Right Care Right Place campaign, launched ahead of winter, is continuing to give guidance to the public on the best way to access services, and I thank everyone who is following that advice.

“The Scottish Government’s draft Budget, if passed by parliament, will provide a record £21 billion for health and social care, including £200 million to reduce waiting lists and improve capacity further.

“All of this will help to improve the flow of patients through hospital, and reduce pressures on urgent care. I urge parliament to back the Budget Bill.”

Technical Report: Redesign of Urgent Care Evaluation – gov.scot

More information on the Redesign of Urgent Care.

NHS 24 111 weekday in-hours are 8am-6pm Monday-Friday

Winter plans in place in NHS Lothian

Robust plans are in place across NHS Lothian this winter to help patients receive the right health care in the right place.

The health board, which is already experiencing significant pressures, has geared up for the busiest time of the year.

The numbers of people who need healthcare surges every winter for a variety of illnesses and conditions, including winter bugs, such as flu, COVID, other respiratory illnesses and Norovirus.

NHS Lothian is working closely with the four health and social care partnership in the region – East Lothian, Midlothian, Edinburgh and West Lothian – to focus in on more community-based initiatives to reduce the need for hospital attendance and admission in the first place.

The move also means that more patients will be able to receive the care they need closer to home and if they do have to be admitted to an acute hospital, the length of their stay in hospital should be shorter.

In turn, the renewed focus on community programmes will help free up more hospital beds for patients who are acutely unwell.

Dr Tracey Gillies, Medical Director, NHS Lothian, said: “The pressures facing hospital and community teams, GPs and pharmacies regularly surge beyond levels of activity that some years ago would normally have been associated with winter.

“That level of demand will only increase as winter progresses, so we have worked with partnerships to bolster their capacity in the community to ensure that more hospital beds are available for those that need them most.

“Health care is there for everyone who needs it this winter and we want to make sure patients can receive their advice, care or treatment in the right place at the right time.”

Health and Social Care Partnerships (HSCPS) across Lothian are enhancing their “discharge to assess” programmes which helps support people to leave hospital as soon as it is safe and appropriate.

Single points of contact (SPoC) services are also being boosted. These systems are aimed at people who are at imminent risk of hospital care but can be safely managed in the community. They support GPs and other professionals to rapidly coordinate services.

Other streamlined assessment processes have also been put in place to expedite hospital discharges and help community teams to proactively identify people ready for discharge with their support.

People across Lothian are being reminded to seek care in the right place this winter – and that in many cases they may get help sooner and closer to home, without attending an A&E department.

The NHS Inform App is the first stop for self-care and advice, while local pharmacies, GP, or Minor Injuries Unit can provide expert care and treatment, usually closer to home. If patients are unsure where to get help or if they need urgent health care at night or at the weekends, they should call 111 day or night.

In Lothian, patients may be signposted on to other services if they turn up to hospital A&E when they don’t need to be there.

NHS Lothian: Choose the right care in the right place

Get the right care in the right place:

Self-help guides: NHS Inform

Advice about minor illnesses, treatments and medication: Pharmacy

Non-urgent treatment: GP

Urgent, but not life-threatening, help: NHS24 at 111

In a life-threatening emergency, always call 999.

When should I call 111?

The 111 service provides urgent care and advice when your GP, pharmacy or dental practice is closed.

Coronavirus

If you need advice about coronavirus, you can find more information on NHS inform or use our online symptom checker for the quickest way to check your symptoms and next steps. This may save you time and help you to decide if you need to phone.

If you or your friends and family would prefer to use an automated phone checker phone 0800 22 44 88.

What service do I need?

If you have a health concern, or you are struggling with your mental wellbeing, you can find information on what to do next via our symptom checkers. These interactive guides will tell you who to contact and provide you with the advice and guidance you need.

Your community pharmacy is also available and can provide advice and treatment for a wide range of conditions including indigestion, diarrhoea or constipation, aches and pains, emergency medication and the morning after pill.

During normal working hours always contact your own GP for urgent advice and treatment. The 111 service cannot arrange appointments at your GP.

When your GP is closed and you cannot wait until they are open, you should phone 111 for out-of-hours advice.

Phone 111 …

If you think you need A&E, but it’s not a critical emergency.

Phone 111 before you attend A&E. This service is available 24 hours a day, 7 days a week.

This service will provide you with urgent care you’ll be assessed for a range of concerns including cuts, burns, suspected broken bones, sprains and other injuries or illnesses.

This may involve a telephone or video consultation with a clinician from your local health board or an appointment to attend A&E or Minor Injuries unit, avoiding a long wait in a hospital waiting room.

Phone 999 or go straight to A&E . . .

For life or limb-threatening emergencies.

This might include a suspected heart attack or stroke, severe breathing difficulties, severe bleeding or severe injury.

When we’re busier than usual

During our busy times, when there’s lots of people calling us, it might take a little longer for us to answer your call.

Our busiest times are:

  • 6pm until 8pm weekdays
  • 9am until midday on Saturdays and Sundays

 If your call is urgent, please hold on because we will answer.

If you think you need to visit A&E but it isn’t a critical emergency please call 111 for expert help to get you to the right place for treatment.

111 can make appointments at our services, reducing the time you spend in busy hospital waiting rooms.

Visit: http://ow.ly/umzp50Hi2rR