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

Figure 7.31 E&UC CIG Responses to NCAT recommendations
NCAT recommendation CIG response See section
What is the case mix going to
be for each of the UCCs and
what is it for the EDs
How will patients who are seen
by a private AQP in an UCC
who are then transferred to an
ED be costed and what is the
scale of this work (this model
has recently started in the West
Middlesex Hospital and there
may be valuable data to apply
in any modelling). What cost
efficiencies will be realised in
this type of model versus an
integrated EM service
What is the staffing model for
each of the UCCs and EDs
based upon the above. It is not
enough to say “we want ED
Cons on 24/7 basis in the big
centres”. Indeed it is unlikely
that ED Cons on a 24/7 basis
will be achievable at any of the
centres in the foreseeable
future.
What is the likely cost model of
expanding the EM senior
workforce to provide that level
of cover and what are the likely
timescales to coincide with the
proposed reconfiguration
What is the depth of the senior
decision makers (ie. number of
senior decision makers on at
any one time during peak
periods) in the EDs to cater for
the high intensity workload and
how will they ensure it is a
sustainable multidisciplinary
workforce that they have
created within a wider EM
system in the NWL health
economy
Clinical scope of UCCs defined using
clinical exclusion criteria.
Criteria used to inform activity model,
allowing calculation of likely
volumes.
We are paying a rate below A&E
tariffs for UCC attendances. The
lower tariff is justified due to the
narrower scope of diagnostics and a
different case mix at UCCs. As
UCCs see the majority of urgent care
work this provides a cost efficiency.
Furthermore UCCs are incentivised
to reduce re-attendances.
Minimum ED staffing requirements
defined by LHP and endorsed by the
E&UC CIG
ED consultant requirements
calculated using LHP „level of cover‟
assumptions (i.e. 16hrs per day, 7
days a week)
Minimum competences and levels of
cover for UCCs agreed by CIG.
Standards around GP cover and
„primary care ethos‟ defined.
CIG recommendation that it is more
appropriate for specific UCC staffing
models to be agreed locally between
UCC commissioners and providers
ED consultant requirements
calculated using LHP „level of cover‟
assumptions (i.e. 16hrs per day, 7
days a week)
Further work is required to identify
the cost implications of the revised
levels of cover. This work will be
taken forward by the F&BP work
stream in January and February
2013.
Minimum ED staffing requirements
defined by LHP and endorsed by the
E&UC CIG
ED consultant requirements
calculated using LHP „level of cover‟
assumptions (i.e. 16hrs per day, 7
days a week)
Section 7.14.2 - UCC
clinical scope
Section 7.3.1 - LHP
Emergency
Department clinical
standards
Chapter 14 – UCC
workforce standards
Section 7.3.1 - LHP
Emergency
Department clinical
standards
Section 7.3.1 - LHP
Emergency
Department clinical
standards
7b. Work of the Emergency and Urgent Care CIG 149