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

7.15.5 Governance
In the opinion of the E&UC CIG, the same standards of governance should be applied to all
UCCs in NWL, irrespective of whether they are co-located with an ED. This will result in the
need for non co-located UCCs to partner with an appropriate ED for the purpose of
overseeing joint governance arrangements (e.g. a Joint Clinical Governance Group). When
selecting an ED partner, existing relationships and patient flows should be considered.
Partnership arrangements should be agreed with local commissioners.
Feedback from clinicians and managers across UCCs and EDs highlighted the importance
of strong informal relationships as the foundation for effective joint working. Because they do
not share a site with an ED, developing and maintaining these relationships will be more
challenging for non co-located UCCs. With this in mind, the E&UC CIG emphasises the
importance of achieving absolute clarity around organisational interfaces.
Recommendations
1. Consistent approach to governance across co-located and non co-located UCCs.
2. Required to establish a formal partnership arrangement with a named ED. This partnership
should include oversight of joint governance arrangements (e.g. a Joint Clinical Governance
Group), patient transfer protocols, staff rotation and training.
3. Clarity around organisational interfaces, handovers and expected response times.
4. Clear emergency care pathways for sourcing specialist advice when needed.
5. Develop a robust governance framework for remote working, covering where clinical
responsibility for the patient lies in circumstances where remote specialist input is provided.
6. Establish strong formal and informal relationships between UCC and ED clinicians and
managers. This could be achieved by removing barriers to effective communication. For
example, developing contractual arrangements to ensure that ED clinicians do not feel that they
are being asked to provide „free‟ advice across organisational boundaries. Requirement to
provide specialist input would need to be specified in „job plans‟.
7.16 UCC integration with primary care
The UCC is required to develop the distinctive culture and approach of a primary care
service. With this in mind, a key element of the UCC operating model is effective integration
with local primary care services in general, and General Practice in particular. The minimum
standards set out above articulate how integration could be achieved. For clarity, this section
summarises the steps UCC providers must take to integrate with primary care under two
headings:
Minimum standards for integration with primary care
Recommendations for local determination.
7.16.1 Minimum standards for integration with primary care
The UCC ICT processes should be inter-operable with both GP and Trust systems in
order to facilitate effective information sharing
The UCC will develop the distinctive culture and approach of a primary care service
working with hospital and secondary care clinicians, with experienced and
appropriately skilled primary care clinicians leading the service
The UCC will ensure full integration with 111 service, both for patients „referred in‟ to
the UCC, and when referring patients into community services and General Practice.
This will include access to the 111 Directory of Service
Patients attending who do not have urgent care needs will be supported by the staff
in the centre to access advice and care from their local community pharmacist, or to
7b. Work of the Emergency and Urgent Care CIG 176