Out of Hours Services in the Spotlight: what can we learn from recent reviews?. Rick Stern Director, Primary Care Foundation , NHS Alliance Lead for Urgent Care [email protected] 07709 746771. - PowerPoint PPT Presentation
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Summarise and reflect on the key points from two reports on out of hours services:
1.General Practice Out-of-Hours Services: project to consider and assess current arrangements (February 2010) David Colin-Thomé, Department of Health & Steve Field, Royal College of General Practitioners
2.Improving out of hours care: what lessons can be learned from a national benchmark of services? Reflections and recommendations for commissioners and providers of out of hours services in England based on the first two rounds of the benchmark in 2009 (January 2010). Henry Clay, Primary Care Foundation.
Key areas in the Department’s ReviewGeneral Practice Out-of-Hours Services: project to consider and assess current arrangements (February 2010) David Colin-Thomé, DH & Steve Field, RCGP● Commissioning and performance management,
including tackling inappropriate variation ● Selection, Induction, Training and use of out-of-
hours clinicians (including the use of locums)● Management and operation of Medical
● As a minimum, doctors should be able to:● Converse with patients or their helpers● Able to read and understand the BNF● Talk to pharmacists & other healthcare professionals● Able to arrange admissions to hospitals
● Better sharing of information across PCTs nationally
● Patient Safety● A new initiative for rapidly sharing learning? ● tighter rules or a cultural shift?
● Focus on learning and improvement● responding to benchmarking and other comparisons across and
within organisations● Better internal scrutiny – good governance and independent NEDs● Greater openness and transparency
● Working as part of an integrated system● Networks and accountability● Three Digit Number● Clarity for the public and patients about using urgent care services
● Commissioning for quality● Commissioning pathways● identifying the cost of quality in urgent care services
Learning from the first two rounds of the benchmarkImproving out of hours care: what lessons can be learned from a national benchmark of services? January 2010, PCF
1. Out of hours services are improving. Most providers have made a rapid transition from ‘rota organising clubs’ into true healthcare providers. In doing so they have got much better at:● Matching capacity to predictable demand, giving ample time for
clinicians to do their work well● Meeting performance standards● Introducing governance processes to ensure a consistent and
safe response to patients● Engaging local clinicians in the service.
Learning from the first two rounds of the benchmark
2. Patients value a responsive service and associate this with good care. There is a wide difference between wide the difference is between the responsive and the comparatively slow.
Learning from the first two rounds of the benchmark
3. There are a number of different models for out of hours provider services. Split services and double assessments seem to perform less well than currently reported.
Learning from the first two rounds of the benchmark
4. Many providers are falling short on the standard for definitive clinical assessment of urgent cases which we see as an important issue of patient safety.
Learning from the first two rounds of the benchmark
5. There is an enormous range across different services in the proportion of cases that are identified as urgent and particular attention should be paid to those that are well below the norm.
Learning from the first two rounds of the benchmark
7. We have suggested three criteria to arrive at a small number of 'good all-rounders'. Our conclusion is that those that perform well on all these factors are far from being the most expensive, but also that the very cheap providers do not appear to have the management headroom to perform consistently enough to feature in this group.
From variation across organisations to variation between clinicians● There is substantial variation within a typical service
between individual clinicians. The response will often be shaped more by who deals with the case rather than the details of the case itself.
● Developing a consistent, safe and appropriate response does not just involve looking at the outliers, but involves consistent feedback to individuals comparing them with their peers so that they can identify specific things that they might do differently for the benefit of patients and the service.