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

Key differences
Governance
As with co-located UCCs, non colocated
UCCs will be expected to
establish a formal partnership with a
named ED.
UCCs must develop a robust
governance framework for remote
working.
Rationale
Oversight of joint governance
arrangements, patient transfer, staff
rotation and training are crucial preconditions
for integrated care.
A clear understanding of where
clinical responsibility lies is essential
in circumstances where remote
specialist input is required.
The following sections set out E&UC CIG recommendations for non co-located UCCs in
detail. All of the recommendations for co-located UCCs set out in section 8 apply equally to
non co-located UCCs, unless explicitly stipulated below.
7.15.1 Clinical scope
In the opinion of the E&UC CIG, expanding the scope of non co-located UCCs to cater for a
broader case-mix than their co-located UCC counterparts has a number of drawbacks:
Risk of duplicating existing ED services
Increased clinical risk in the absence of on-site ED support
Confusion for service users attempting to navigate the system
Requirement to build capacity and capability that would be rarely used, increasing
costs.
However, the absence of on-site ED support will mean non co-located UCCs will require
some capabilities that may not be needed at co-located UCCs, even if the case-mix remains
the same. For example, staff will need additional training in order to deal with emergencies
and unusual cases.
As with co-located UCCs, non co-located UCCs will have 24/7 access to a Psychiatric
Liaison Team. 24/7 access to psychiatric liaison will be provided by the Psychiatric Liaison
Team present at an appropriate partner ED. When deciding which Psychiatric Liaison Team
will provide cover, consideration should be given to the team‟s base location and the Mental
Health Trust provider involved.
Recommendations
1. Co-located and non co-located UCCs should provide care to the same clinical standards.
2. Patients that do not meet the UCC clinical exclusion criteria and require onward transfer to an
ED should be assessed immediately by a clinician. Arrangements should be put in place to
facilitate their immediate transfer to ED (or other specialist service) if clinically appropriate.
3. Non co-located UCCs should have the ability to manage the full range of emergency and urgent
care presentations.
4. It is critical that UCC staff have the appropriate skills to undertake streaming and initial
assessment quickly and effectively.
5. 24/7 access to psychiatric liaison will be provided by the Psychiatric Liaison Team present at the
UCC‟s partner ED.
7.15.2 Initial assessment
As patients requiring ED services will require transport off site, early identification of
seriously ill patients is crucial. The E&UC CIG believes that clinicians at non co-located
7b. Work of the Emergency and Urgent Care CIG 169