1. Unscheduled Care Taskforce - NIAS Transformation Programme Sarah Williamson – Transformation and Organisational Change Programme Manager Ciaran McKenna – Clinical Service Improvement Lead Sarah Williamson – Transformation and Organisational Change Programme Manager Ciaran McKenna – Clinical Service Improvement Lead

2. NIAS Transformation & Modernisation Programme TYC ICP led projects Acute hospital redesign Acute hospital pressures

5. SeeAssess Treat Convey See Assess Convey TRADITIONAL MODEL NEW PATHWAYS Hear Assess SeeAssess ED Refer/ Convey Treat GP/OOH MIU ED Community Nursing Frail/Elderly Service Specialist Services Leave Refer/ Convey

6. NIAS Alternative Care Pathways Alternative Care Pathways Diabetes Cardiac Minor Injuries Community Nursing Referrals (eg for Blocked Catheters) Falls Epilepsy Mental Health COPD Palliative Care Frequent Callers Clinical Support Desk Asthma Nursing home patient pathways Alcohol-related episodes Next steps for Cardiac & Stroke

7. See and Treat and Refer or Hear and Refer Potential Alternate Care Pathways Minor Injuries Blocked Catheters Palliative Care Falls Epilepsy Mental Health COPD/Asthma Frail/Elderly In order to implement…we need access to: Primary Care (in hours & OOH) Minor Injuries Units District Nursing Services/ Rapid Response/Palliative Care Falls Teams Crisis Response Rapid Response from Respiratory Teams Acute Care at Home teams

8. Clinical Support Desk - Plans for pilot have been approved - Paramedic-Led for six months Decision Support Software Enhanced secondary triage Signposting to appropriate services Support to crews

9. Directory of Services - Procurement underway - Hosted by NIAS relating to NIAS referral pathways and ACPs - Pivotal to success of this is access to services

10. Appropriate Care Pathway NIAS Read- iness RAG Status - NI Belfast South East SouthNorthWest Diabetes Cardiac Minor Injuries N/A Falls Frail/Elderly District Nursing Palliative Care Seizures Respiratory 15/16 Mental Health 15/16

11. Appropriate Care Pathway NIAS Read- iness RAG Status - NI Belfast South East SouthNorthWest Falls Biggest reason for calls 3 different models being proposed for Rapid assessment with pros and cons to each. SET – Band 4 Falls Assessors – home visit Southern – Band 7 Physiotherapist - phone assessment Northern Band 6 Nurse - phone assessment We need consistency and services asap in West and Belfast.

12. Appropriate Care Pathway NIAS Read- iness RAG Statu s - NI Belfast South East SouthNorthWest Palliative Care ’Go live’ 20/04/15 Working with HSCB & Marie Curie Discussions underway in Belfast and SET Referrals via OOH Contingency/support from OOH crucial

13. Appropriate Care Pathway NIAS Read- iness RAG Status - NI Belfast South East SouthNorthWest Community Nursing Go-live is TBC Discussions underway in all Trusts (some more productive than others) Significant variation (eg management of IVs) Variety of referral pathways and phone numbers within each Trust Encouragement from top teams needed…

14. Thank you!