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

in major hospitals) and equipment to support the networks of GP practices where much care
in the future will be delivered, and a place for access to urgent care when required.
Specialists will be full members of the wider out-of-hospital team, making their contribution to
planned and personalised health and care. Indeed, GP services, community services, and
social care may also be co-located in local hospitals, bringing the full range of services
together around the needs of patients, close to home. Further details about local hospitals
can be found in Chapter 16.
7.6.2 Urgent care centres
When individuals have urgent needs, it is important that they can access the advice or care
that they need as rapidly as possible. In the new system of out of hospital care, people will
be able to access services through a number of routes. These include community pharmacy,
extended GP opening hours, such as weekends and evenings (within an individual practice
or the practice network), greater availability of telephone advice from the practice or through
111, and GP out-of-hours services.
Today, many people with a wide range of urgent illnesses and injuries are seen by A&E
departments when they could be cared for more appropriately and closer to home by a
primary care urgent care service. For that reason, all local hospitals will have an urgent care
centre (UCC) that will be open 24/7 – and fully integrated with the wider integrated and
coordinated out-of-hospital system to ensure appropriate follow up. UCCs specialise in the
treatment of patients with emergency conditions that do not need hospital admission. They
have strong links with other related services, including GP practices and pharmacies in the
community. They are also networked with local A&E departments, whether on the same
hospital site or elsewhere, so that any patients who do attend an UCC with a more severe
complaint can quickly receive the most appropriate specialist care. Further details about
UCCs can be found in Section 7b.
7.6.3 Major hospitals
Major hospitals will provide a full range of acute clinical services.
They will have sufficient scale to support a range of clinically
interdependent services and to provide high quality services for
patients with urgent and/or complex needs. At their core they will
be equipped and staffed to support a 24/7 A&E with 24/7 urgent
surgery and medicine and a level 3 ICU. Major hospitals will also
provide a psychiatric liaison service as well as maternity services
with appropriate consultant cover alongside interventional
radiology services. They may also host complex surgery, a hyper-acute stroke unit (HASU),
inpatient paediatrics, a heart attack centre (HAC) and a major trauma centre.
In NW London each major hospital would also provide local hospital services, particularly
access to an urgent care centre.
7.6.4 Elective hospitals
Elective hospitals will provide patients with non-complex elective medicine
and elective surgery services, including operations such as hip replacements
and cataract operations. Elective services are planned, non-emergency
services. The advantage of dedicated elective centres is that they allow
clinicians to focus on the delivery of elective services without complexity of
also seeking to provide unscheduled services, which can reduce efficiency.
Elective hospitals can be located within, or independently of, major hospitals
as they do not rely on any of the specialist services of a major hospital. Local clinicians
7a. Clinical vision, standards and service models 129