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

8d. Urgent care centres
When individuals have urgent medical needs, it is important that they can access advice or
care 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, greater availability of telephone advice from the practice or through 111,
and GP out-of-hours services.
Today, many patients present at A&E with conditions that could be managed more
appropriately in primary care. To ensure that these patients are treated in a setting
appropriate to their clinical need, it is proposed that urgent care centres will be provided at
all hospital sites on a 24/7 basis. Essential features of the UCCs would be:
Treatment - where possible, UCCs will seek to resolve the patient‟s health problem
conclusively. This means that the patient will be able to return home with their
problem addressed, for example, with a clear plan for self-management or for further
appointments with their GP or another NHS provider. The UCC will be capable of
treating patients with a wide range of illnesses and injuries. This will include the
interpretation of X-rays and other diagnostics and investigations, the treatment of
uncomplicated fractures, non-complex regional anaesthesia for wound closure,
incision and drainage of abscesses not requiring general anaesthesia and minor ENT
and ophthalmic procedures. Follow-up where it is clinically necessary, would take
place in the UCC. Other types of follow-up care (for example, wound management)
are undertaken by other out of hospital services under the care of the patient‟s own
GP
Escalation - clinicians within all UCCs will be competent to assess and stabilise
patients requiring transfer to A&E departments. When the A&E department is not on
the same site, agreed protocols will be in place to ensure rapid transfer to the
appropriate specialist service. Examples might be patients with a complex fracture of
upper and lower limbs and likely to require manipulation and patients needing
procedures requiring sedation. Furthermore, clinicians in UCCs will develop strong
working relationships with those in acute facilities; this will extend to the rotation of
staff between acute and urgent care facilities to strengthen the bond between them
Health and social care rapid support service all UCCs will be linked with
community services to allow for an immediate assessment of needs, so that the
appropriate package of services is in place for when the patient returns home. For
example, patients who require meals on wheels to support independent living
Admission to community beds - all UCCs will be able to admit patients to
community beds if their assessment indicates that this is appropriate. In some cases,
these community beds will be on the local hospital site
Signposting - all UCCs will work collaboratively with colleagues in general practice
to ensure that, when appropriate, patients are advised to seek care from their local
GP in future instances. In addition, UCCs will support people to register with a local
GP in cases where they are not already registered.
It is estimated that 60-80% of the patients currently seen within A&E could be seen at a
UCC.
The Emergency and Urgent Care CIG has recommended a single, consistent operating
model, with appropriate localisation, be implemented at all NW London UCCs. Further
details on UCCs are found in Section 7b.
8d. Urgent care centres 251