Establishing a 24/7 acute primary care visiting service

Improving primary urgent care

The case for change

• delivering the 4 hour waiting time in A&E• contribute to save 25% admissions to hospital deemed

unnecessary • North West Ambulance Service (NWAS) estimate 40% of

all 999 calls can be more appropriately managed outside of A&E

• Support for NWAS to achieve the Category A target of 75% - (8 minutes from call to attendance)

• adding support to primary care so they can focus on proactive support

Opportunities….

• A well established, high quality out of hours primary care service staffed by local GPS

• NWAS Pathfinder scheme -trained paramedics select from alternate pathways for patient care

• additional resource as part of the ‘winter monies’• well established urgent care group of health and social

care partners and clear plans for improvement

What we did….

• pilot an extension of out of hours service to cover 24/7 and provide an acute visiting service (AVS)

• AVS provide a 2 hour response time to NWAS pathfinders, some care homes and GP practices during surgery time

• utilising winter pressures money to increase capacity in the Out of Hours service

• monitor improvements against and agreed set of objectives

The difference we have made….

• in the first 6 weeks 128 people were cared for at home instead of being taken to hospital

• more than 95% of people attending A&E were seen in 4 hours or less during the winter months

• care planning supports patients and GPs working together, care will feel more joined up and tailored to need care

• NWAS Category A performance improved

Next steps and future plans

• the service will continue for the next 12 months , expand to support complex discharge from hospital

• additional evaluation on patients still at home after 30 days

• ensure the users of the service have ample opportunity to comment on and shape future services