Primary Care Out-of-Hours Services - NHS Lanarkshire

Meeting ofLanarkshire NHS BoardLanarkshire NHS Board14 Beckford StreetHamilton ML3 0TATelephone 01698 281313Fax 01698 423134www.nhslanarkshire.co.ukSUBJECT: PRIMARY CARE OUT OF HOURS OCTOBER 20101. PURPOSEThis report provides the Board with information on the performance of thePrimary Care Out of Hours Service for October 2010.2. SUMMARY OF KEY ISSUESThe service was stable in activity terms during October with activity down alittle on that for the same period in 2008 (which was a comparable month).The Service continued to experience some difficulties in filling doctor shifts atthe weekends, mainly due to annual leave and a temporary gap inrecruitment. A recruitment drive with local practices and the Glasgow LocumGroup is aiming to address the issues both now and into the near future.3. ACTIONS FOR THE SERVICEWinter planning is now well underway in planning and preparation terms.However there has been a loss of several doctors from the festive rota whonormally fill a good number of the more challenging shifts. The result is thatthere are now gaps in the rota on four days amounting to 60 slots.The OOH service is actively working to fill these shifts by exploring variousavenues such as Glasgow Locum Group, the Lanarkshire LMC, and OOHpartners. In addition a range of potential contingency arrangements are beingdrawn up to manage the situation on the affected days.Staff meetings regarding the new model for OOH service took place inOctober, and the 7pm start in the Primary Care Emergency Centres willcommence on 1 December. Dates have been arranged to meet withindividual salaried doctors to progress the Cumbernauld and Lanark staffingreduction.4. RECOMMENDATIONThe Board is asked to note the performance of the Primary Care Out of HoursService over October 2010.

5. FURTHER INFORMATIONFor further information or clarification of any issues in this paper pleasecontact.Alan Lawrie Director South Lanarkshire CHP 01698 245194Dr. Liz Duncan Clinical Director OoH Service 01698 377606Lena Collins Locality General Manager 0141 584 25092

Summary Activity & Performance Report for October 2010Descriptor Sept 2010 Oct 2010 Narrativea. OOH ACTIVITYNumber of patients calling NHS 24 in OOH period 8810 8856Number of NHS L patients triaged in local centre 1621 1426% NHS L triaged in local centre 18.4% 16.1%Total calls triaged in local centre 3512 3814Total number of patient contacts with OOH Services 9568 9293 This figure includes 515 transfers from A&E to OOH Serviceb. OOH PERFORMANCE TargetTime for NHS 24 nurse to commenceconsultation• % urgent commenced within 20 minutes• % non urgent commenced within 60 minutesResponse time for Home Visits• 1 hour• 2 hours• 4 hoursTotal home visits99.96%99.81%71%87%89%125299.98%99.90%78%89%95%125795%90%75%75%90%KPI monitored by NHS 24Percentage of rostered doctor sessions filled 99% 95% 100% On-going problems filling weekend shiftsData to GP Practice by 0930 on next working dayDental performance• Total No of contacts (calls handled by DTNs inLanarkshire)Outcome of Triage:• Emergency appointment (within 1 hr)• Urgent Appointments (with 24 hrs)• Self care & other100% 97% 99%68139 (6%)459 (67%)183 (27%)Due to server problems some practices did not receive callslips via electronic system and calls were manually faxed.This fault was on-going for 9 days.No figures available at presentCommunity Nurse Performance• No of new referrals• Total no of home visitsc. CLINICAL GOVERNANCESignificant Adverse EventsComplaints• No. received• No. responses out with the standard time404203600479203220Stable service.

APPENDIX 1 – OUT OF HOURS LANARKSHIRE EMERGENCY DENTAL SERVICEMONTH OF OCTOBER 2010PERIOD – 4 WEEKS FROM 04/10/10-31/10/101. APPOINTMENTS MADE AND FAILED TO ATTEND (FTA)255 PATIENTS WERE GIVEN AN APPOINTMENT TO ATTEND THE CLINICS IN WISHAW GENERAL HOSPITAL AND 27 (11%)FAILED TO ATTEND.JUST OVER 1 IN 10 PATIENTS FAILED TO ATTEND THEIR APPOINTMENT.54 PATIENTS WERE GIVEN AN APPOINTMENT TO ATTEND FOR 'NEXT DAY, MONDAY -FRIDAY ' CARE AND 12(22%) FAILEDTO ATTEND.JUST OVER 2 IN 10 PATIENTS FAILED TO ATTEND THEIR APPOINTMENT.2. SUMMARY OF TREATMENT PROVIDEDWISHAW GENERAL HOSPITAL228 PATIENTS ATTENDED THE CLINICS IN WISHAW GENERAL HOSPITAL. 71 EXTRACTIONS WERE CARRIED OUT, 14DRESSINGS WERE PROVIDED AND 153 PRESCRIPTIONS WERE ISSUED, 15 X-RAYS TAKEN & 81 OTHER TREATMENTSPROVIDED FOR PATIENTS.NEXT DAY CARE42 PATIENTS ATTENDED NEXT DAY CARE. 14 EXTRACTIONS WERE CARRIED OUT, 5 DRESSINGS WERE PROVIDED AND 21PRESCRIPTIONS WERE ISSUED, 2 X-RAYS TAKEN & 14 OTHER TREATMENTS PROVIDED FOR PATIENTS.The treatments provided are the type of treatments associated with relief of pain and discomfort – genuine emergency dental care.AS A RESULT OF ATTENDING NEXT DAY CARE 54% OF PATIENTS REGISTERED WITH THE TREATING DENTIST AND 46% DIDNOT.One of the key aims of the service is securing registration with a dentist. The level of registration with the dentist providing ‘next day’ careis above expectations (50%)4

3. GENERAL COMMENTOverall the OOH Emergency Dental Service continues to be delivered in a reliable manner and the working relationship with the NHS24Triage service is effective and efficientAPPENDIX 2 – OUT OF HOURS LANARKSHIRE EMERGENCY DENTAL SERVICENo figures are available from NHS 24 for October 2010.80%Lanarkshire Heath Board Triage Dispositions70%60%50%40%30%20%10%0%% Emergency % Urgent % Routine % OtherAug-10 6.8% 71.8% 17.2% 4.2%Sep-10 5.7% 67.4% 21.6% 5.3%5