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Single access model - past, present & future Paul Wilding - Medical Director NHS Direct West Yorkshire.

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Presentation on theme: "Single access model - past, present & future Paul Wilding - Medical Director NHS Direct West Yorkshire."— Presentation transcript:

1 Single access model - past, present & future Paul Wilding - Medical Director NHS Direct West Yorkshire

2 Background Calderdale GP PENDOC NHS Direct West Yorkshire

3 NHS Direct nurse triage Patient calls PENDOC controller General practitioner review GP telephone advice 46% Home visit PCC appointment Nurse tel. advice 999/A&E 21% 52% 33% 43% 5%

4 Single access model - past, present & future how did we get started? (1) clinical leadership coincidence - opportunity seized mutual commitment to partnership working shared objectives - seamless patient centered high quality care, demand management

5 Single access model - past, present & future how did we get started? (2) progressing a good idea - single number access to multi-disciplinary OOH care clear benefits to patients and all stakeholders pushing against an open door resources - central and local

6 Single access model - past, present & future how did we get started? (3) In summary: foundation for the future

7 Single access model - past, present & future how has the model changed over time in unexpected ways? Increased coverage

8 Single access model - past, present & future how has the model changed over time in unexpected ways? PENDOC coverage GPs85,000 patients ,000

9 Single access model - past, present & future how has the model changed over time in unexpected ways? clinical governance outputs – audit, performance & risk management co-location of ambulance control

10 Single access model - past, present & future how has the model changed over time in unexpected ways? mental health NHS CAS - wider role out stalled, call- times and triage outcome single telephone assessment call-streaming

11 NHS Direct nurse triage Patient calls PENDOC controller General practitioner review GP telephone advice 46% Home visit PCC appointment Nurse tel. advice A&E & Others 21% 52% 33% 43% 5%

12 Single access model - past, present & future How will the model look in the future?

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14 Single access model - past, present & future What else was unexpected? pace of NHS policy initiatives Carson Review, REC (GMS GP Contract) sense of urgency – PCT OOH funding time bomb

15 Single access model - past, present & future How did the development broaden out? dental services, community nursing leadership - managerial & clinical communication & marketing extension to in-hours cover

16 Single access model - past, present & future How did the development broaden out? by accessing local expertise e.g. palliative care to create a special patient pathway

17 Single access model - past, present & future How can we grow connections with other parts of the system in the future? dedicated unscheduled care provision by all agencies across the 24 hour divide technology – EPR (and compliance with with confidentiality requirements)

18 Single access model - past, present & future How are we overcoming professional boundaries and traditional roles? communicating the vision of a multi- disciplinary OOH workforce and telephone triage service managing sensitivities e.g. GPs attracting new investment – Developing NHS Direct

19 Single access model - past, present & future How did we overcome professional boundaries and traditional roles? extension to in-hours cover GPs benefiting from locality NHS provision towards a 24x7 emergency access model

20 Single access model - past, present & future How can we overcome professional boundaries and traditional roles in the future? working with the wider NHS e.g. MA Changing Workforce Programme, NHS Direct

21 Single access model - past, present & future How can we overcome professional boundaries and traditional roles in the future? by a delivering safe & effective service acknowledging different attitudes to risk/uncertainty be pragmatic e.g. selected caseload

22 Summary pole position for progressing a regional approach towards a single access pathway to emergency/ unscheduled care manager/clinician partnership all agencies must be engaged Primary Care must assume a leading role in Emergency Care Networks

23 Thank You!


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