SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

Figure 7.11: Shaping a healthier future urgent care centre standards, core service:
No. Standard Adapted from source
3
During the hours that they are open all
urgent care services to be staffed by
multidisciplinary teams, including: at least
one registered medical practitioner (either a
registered GP or doctor with appropriate
competencies for primary and emergency
care), and at least one other registered
healthcare practitioner.
Healthcare for London (2010) A service delivery
model for urgent care centres
Supporting information:
The registered medical practitioner and registered healthcare practitioner should not be staffed using
clinical cover from staff working in an emergency department.
At any time the service is open the team on duty is to have the ability to manage a patient attending
for minor injury and illness and complete an episode of care. This requires the team to be competent
in the practical skills necessary to identify and manage non-complex soft tissue and bone injuries,
such as suturing under local anaesthesia, wound closure, plaster casting and assessment of burns.
4
An escalation protocol is to be in place to
ensure that seriously ill/high risk patients
presenting to the urgent care service are
seen immediately on arrival by a registered
healthcare practitioner.
Supporting information:
The escalation protocol is to be understood by all members of staff both clinical and non-clinical at
the urgent care service.
The escalation protocol is to be documented, displayed and reviewed annually.
For emergency cases an urgent care service is to arrange immediate transfer to an emergency
department (by calling 999 if not co-located with an emergency department).
While waiting for an ambulance to arrive the urgent care service should instigate appropriate clinical
management.
The urgent care service should ensure full integration with the directory of services (e.g. via 111) to
assist patients accessing the most appropriate services.
5
All patients are to be seen and receive an
initial clinical assessment by a registered
healthcare practitioner within 15 minutes of
the time of arrival at the urgent care
service.
Healthcare for London (2010) A service delivery
model for urgent care centres
DoH (2006) National Quality Requirements in
the Delivery of out-of-hours services
RCPCH (2012) Standards for children and
young people in emergency care settings
Primary care foundation (2012) Urgent care
centres: what works best
Supporting information:
Time of arrival at the urgent care service is defined as the time a patient is registered at the point of
arriving at the urgent care service.
Initial assessment includes a pain score and where needed, early pain relief should be initiated
during the initial clinical assessment.
During initial clinical assessment patients should be identified for imaging or diagnostic tests that
might be required so these can be initiated early.
Clinical staff carrying out the initial consultation are to have the necessary skills to complete the
majority of cases and are to be able to order relevant diagnostic tests.
Where possible, when clinically necessary immediate treatment is to be given. „See and treat‟ is the
optimal model of care.
If inappropriate for urgent care services the patient may need to be transferred to the partnered
emergency department.
Patients attending who do not have urgent care needs should be supported by staff in the urgent
care service to access advice and care from their local community pharmacist, or to make an
appointment with their own GP practice or an alternative community service. Urgent care service
staff to have access to the 111 Directory of Service to support this process.
6 Within 90 minutes of the time of arrival at Healthcare for London (2010) A service delivery
7a. Clinical vision, standards and service models 107