2. Jarrow NDUC – North Scotswood Eston Grange Vocare North East Locations NDUC - Tees

3. North East Operations Centres

4. Northern Doctors Urgent Care North East Ambulance Service North East NHS 111 Service

5. North East NHS 111

6. 19968002.3 million£23 million Vocare Group Facts

7. Northern Doctors Urgent Care

8. GP Led 7 GPs in Senior Clinical Management Team 24/7 Clinical on Call Integrated Group Clinical Review

10. Tees March 2013 NQR Performance NQR1Service Monitoring and Data ReportingNumber of working days following end of relevant month for service to produce report100% NQR2CommunicationPercentage of details of OOH patient consultations (including clinical information) transmitted to the GP practice where the patient is registered by 08:00hrs the next working day. 100% NQR8aInitial telephone callPercentage of calls engaged (no more than 0.1%)100% NQR8bInitial telephone callPercentage of calls abandoned98% NQR8cInitial telephone callPercentage of calls answered within 60 seconds of the end of the introductory message (maximum 30 seconds for introductory message) 96% NQR9aTelephone clinical assessmentPercentage of patients suffering from immediate and life threatening conditions whose calls are passed to the ambulance service within 3 minutes of their condition being identified. 100% NQR9bDefinitive clinical assessment -telephonePercentage of urgent calls where definitive clinical assessment is started within 20 minutes of the call being answered by a person 100% NQR9cDefinitive clinical assessment -telephonePercentage of all other calls where definitive clinical assessment is started within 60 minutes of the call being answered by a person 96% NQR10aFace to face clinical assessmnetPercentage of patients suffering from immediate and life threatening conditions whose are passed to the ambulance service within 3 minutes of their condition being identified. 100% NQR10bDefinitive clinical assessment -face to facePercentage of patients with urgent needs where definitive clinical assessment is started within 20 minutes of the patient arriving at the centre. 100% NQR10cDefinitive clinical assessment -face to facePercentage of all other patients where definitive clinical assessment is started within 60 minutes of the patient arriving at the centre. 100% NQR12aFace to face consultations (either in a centre or in the patient's place of residence) Percentage of patients whose face to face consultation (following definitive clinical assessment) takes place within 1 hour (where classed as an emergency) 100% NQR12bFace to face consultations (either in a centre or in the patient's place of residence) Percentage of patients whose face to face consultation (following definitive clinical assessment) takes place within 2 hours (where classed as urgent) 97% NQR12cFace to face consultations (either in a centre or in the patient's place of residence) Percentage of patients whose face to face consultation (following definitive clinical assessment) takes place within 6 hours (where classed as less urgent) 99% NQR13Access to interpretation servicesPercentage of patients who are unable to communicate effectively in English provided with an interpretation service within 15 minutes of initial contact. 100%

11. Audit NHS Tees A&E Audit carried out by Dr Peter Haywood NHS Tees Period 10 June 2013 to 17 June 2013 NDUC A&E/999 Audit carried out by Dr Edward Summers NDUC

12. Outcomes – A&E 2857 Total A&E Attendances 25 NDUC A&E/999 referrals to A&E 922 NDUC Cases 0.88% of A&E Attendances 2.71% of NDUC Cases NDUC Non NDUC

13. Outcomes – Admissions (not A&E) 7.5% of NDUC cases this week 5.4% of NDUC cases July 2013

14. Total Secondary Referrals (Admissions + A&E/999) National 12-16% (Primary Care Foundation Report of April 2012) NDUC 10% (NDUC Internal)

15. 999 Cases complicated distressed acute retention of urine following cystoscopy that day lab result indicating a heart attack cardiac chest pain with history of previous heart attack ?stroke cardiac chest pain and difficulty in breathing significant overdose of painkillers

16. A+E Cases 3 arranged after face to face assessments – 92yo fall, 93yo fall, 11yo wrist injury after discussion with A&E Consultant 3 sent to A&E after discussion with district nurses regarding patients with catheter problems 2 patients elected to attend A&E despite offer of centre appointment 1 patient sent to A&E after discussion with Gynaecology on call

17. A+E Cases 1 patient called ambulance prior to NDUC Dr telephone assessment 1 patient assessed at 2300hrs with eye symptoms – referred to Eye Casualty Clinic the next morning 6yo with needle stick injury from syringe on allotment 32yo with malaena (significant stomach bleeding) Severe abdominal pain with pain score 10/10

18. A+E Cases abdominal pain incarcerated hernia 12m baby vomiting x40 over 34hrs Suspect ectopic pregnancy/miscarriage Unwell infant ?Croup

19. Total Secondary Referrals (Admissions + A&E/999) National 12-16% (Primary Care Foundation Report of April 2012) NDUC 10% (NDUC Internal)

21. 2012/13

23. Moving Forward Paramedic Support Special Patient Notes Access to GP Patient Records CREAM (Clinical Review Evaluation and Assessment Meetings) SERRG (SEcondary Referral Review Group)