Quelles solutions pour la garde en médecine générale? - KCE

KCE Reports 1771
Items
Affter-Hours
Primaary
Care
Time frame foor
answering to calls:
The national minimum standards fo or the time to answer ccalls,
and proportions of calls that are engaged
or abandoned, arre
set out under nationnal
quality requirementts:
All calls musst
be answered within 60 seconds of the end
of the introductoryy
message which should
normally be no mmore
than 30 secondss
long. Where there iss
no
introductory mmessage,
all calls mus st be answered within 30 seconds.
A three-minute
time standard for emergency
calls, from tthe
time they were ideentified
as an emergenncy,
to be transferred tto
the emergency servvices.
Engaged andd
abandoned calls: No o more than 0.1% of caalls
engaged and no mmore
than 5% calls abandoned.
Time frame foor
urgent and non-urgent
visits:
Providers muust
have a robust syste em for identifying all immmediate
life threatenning
conditions and, oonce
identified, those ccalls
must be passed to the ambulance servvice
within 3 minuutes.
Providers thaat
can demonstrate tha at they have a clinically
safe and effective syystem
for prioritising ccalls,
must meet the foollowing
standards:
Start definitivve
clinical assessment for urgent calls withinn
20 minutes of the calll
being answered by a person.
Start definitivve
clinical assessment for all other calls withhin
60 minutes of the ccall
being answered byy
a person.
Providers thaat
do not have such a system, s must start deffinitive
clinical assessmment
for all calls withinn
20 minutes of the caall
being answered by a person.
There is a seet
of minimum standar rds for time to start, ddefinitive
clinical assesssment
by a clinician (i.e. the last triage assessment
if there is mmore
than one) for urggent
(within 20 minnutes)
and less urgent/routine
calls (within 660
minutes).
The national minimum standards for time from definitivve
clinical assessmennt
to face-to-face connsultation
are set out are broken down intto
three levels of prioority
emergency (wwithin
one hour), urgent
(within two hours) aand
less urgent (withinn
six hours).
Patients will be seen either at the patient’s place of ressidence
or at a primaary
care centre (base) ). As well as the patieent’s
clinical conditionn,
the criteria for decidding
whether to viisit
a patient’s home or o ask them to come tto
a base will vary, buut
will generally take iinto
account location, available transport annd
other relevant factors.
Some patientts
such as those receiving
palliative care will
always receive home
visits.
At the end off
the assessment, the e patient must be cleaar
of the outcome including
(where approprriate)
the timescale wiithin
which further acttion
will be taken and the
location of anny
face-to-face consult tation.
Location:
Situated nearr
or within a hospital, but b there is often no reegulated
flow betweenn
them.
Access:
Calling the seervice
directly or being g diverted after calling either their normal GPP
practice or NHS Direect.
Workload GPPs:
No informatioon
available.
Services:
Triagee
The triage staage
will always be conducted
by clinical meembers
of staff, doctoors,
nurses or emergency
care practitionerss,
and will generally innvolve
the clinician callling
the patient too
conduct the assessm ment over the phone. SSome
providers will haave
face-to-face triagee
available at their primmary
care centres for wwalk-in
patients but many
e
Triage is a method of rankingg
sick or injured peo ople according to thhe
severity of their ssickness
or injury soo
that they receive tthe
right service witth
the appropriate ddegree
of urgencyy.
Results
107