Strategic Framework for GP Out-of-Hours

Strategic Framework for GP Out-of-Hours

Public MeetingPublic Meeting13th August 201213th August 2012

Dr E.G.J. O’NeillDr E.G.J. O’NeillConsultant Medical Adviser Consultant Medical Adviser

Directorate of Integrated CareDirectorate of Integrated CareHealth & Social Care BoardHealth & Social Care Board

Public Consultation

Public Consultation

Closing date – Closing date – 2828thth September September

20122012

Public MeetingsPublic Meetings

OutlineOutline

1. Introduction and background

2. Our plans – Strategic Framework

3. Your say

BackgroundBackground

1. GP Out-of-Hours – for urgent primary care conditions when GP practices are closed

2. 5 provider organisations

3. Last year over 574,000 calls

Call VolumesCall Volumes

When When you you contact contact us…..us…..

TriageTriage Immediately life-threatening:

these calls should be passed to 999 ambulance within 3 minutes.

Urgent: appointment given at initial contact or triage within 20 minutes by a health professional

Less urgent: triage within 1 hour by a health professional

Face-to-face consultationFace-to-face consultation

The health professional will determine if a person needs a face-to-face consultation and the appropriate timescales.

A face-to-face consultation, if required, usually takes place at an Out-of-Hours centre or occasionally at a patient’s home or place of residence.

Face-to-face consultationFace-to-face consultation

Urgent: within 1 hour if required after completion of triage.

Less urgent: within 2 hours if required after completion of triage.

Routine: within 6 hours if clinically appropriate after completion of triage.

How do we do?How do we do?

How do we do?How do we do?

ComplaintsComplaints

In 2011/12 – 99 complaints

574,811 contacts

Complaint rate is approx 0.017%

Strategic FrameworkStrategic Framework

1. Simplify access to GP Out-of-Hours e.g. single telephone number

2. Improve operational efficiency

3. Improve alignment with other healthcare services

Simplify access to GP Out-of-Hours

Simplify access to GP Out-of-Hours

Simplify access to GP Out-of-Hours

Simplify access to GP Out-of-Hours

Simplify access to Simplify access to GP Out-of-HoursGP Out-of-Hours

reducing current telephone numbers from 7 to 1 access number

consolidating the Out-of-Hours six computer systems to one regional system

sharing call handling workload among call centres at busier times

Simplify access to Simplify access to GP Out-of-HoursGP Out-of-Hours

implementing more sophisticated telephony to manage this sharing of call handling workload

improving communication with the public in terms of appropriate use of the service and how to access the service

Operational efficiencyOperational efficiency

continuing to develop standard protocols and processes

standardising clinical governance: including best practice pathways for common presentations and performance management systems

standardising the triage process, through decision support tools, agreed performance management processes, and refinement of triage processes

Operational efficiencyOperational efficiency sharing triage workload across the region

at busier times (calls and consultations) consolidate the number of triage centres

at times of low demand e.g. overnight using technology to co-ordinate and

facilitate home visits: progress towards mobile working at quieter times, where GPs travel to see patients, and Out-of-Hours centres are only opened as required for clinical consultations

ensuring the service is developed in a way that best meets patients’ needs

Alignment with servicesAlignment with services aligning call handling and triage processes with

Northern Ireland Ambulance Service

enhance collaborative working and agree protocols

to facilitate the easier transfer of appropriate calls to the ambulance service

transfer of appropriate “Category C” ambulance calls to the GP Out-of-Hours service

Alignment with servicesAlignment with services retaining provision by local organisations of

home visits to see patients, and the facility to see GPs in local Out-of-Hours centres

allows for future development, to complement and align with the development of A&E (ED) and unscheduled care services

retains flexibility to enable clinical provision which is responsive to local need (through Local Commissioning Groups) and to primary care providers

Alignment with servicesAlignment with services considering the expansion of service

provision (review interface with other services)

staff and infrastructure could be used, for example, to provide a call handling service for other services such as social services contacts during the Out-of-Hours period

Co-location and integration of other services would simplify and improve patient access

Expected benefitsExpected benefits

Service More efficient and better quality serviceBetter management of peaks and troughs Formal common standardsBetter governancePerformance managementFinancial efficiencyDevelopment of the operating modelOptimised use of workforce and centres

Patient Clear patient pathway (single phone number)Removal of geographic boundariesPatient focused informationConsistent processesFaster response at peak timesChoice of centre to attendMore coordinated joined up service

Your SayYour Say

Respond to the consultationRespond to the consultation

Closing date – 28th September 2012

Dr Sloan Harper (GP Out-of-Hours Consultation)Health and Social Care Board

12-22 Linenhall Street

Belfast, BT2 8BS

E-mail: OOH.consultation@hscni.net

Website: www.hscboard.hscni.net