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Integrated Urgent Care Services

Working with Luton CCG, we are reprocuring an Integrated Urgent Care (111 and Out of Hours) Service for Bedfordshire and Luton. 

From March to May we undertook a pre-procurement engagement exercise, this included surveys for members of the public and healthcare professionals (available online and as a paper version). We also held meetings and gave presentations to patient participation groups, Locality Boards, the local System Resilience Group (which includes health and social care provider organisations and local authorities), and local Healthwatch organisations.

We received 223 survey responses from members of the public and 30 responses from healthcare professionals.

The survey was promoted on both CCG's websites and also via social media.  It was cascaded to local health and social care providers and local authorities, CCG memberships, GP practices and released to local media.

The key findings of the survey are shown below.  Full details can be found here.

•   66% of respondents had used GP out of hours services before;

•   Just under 46% had previously called NHS111;

•   Responses revealed a number of issues for people who have respiratory conditions. There were 60 comments relating to respiratory health problems which will be considered for community provision;

•   The majority of calls relate to members of the caller’s own household and there is strong evidence to show that people have been using the GP Out of Hours service appropriately (92.1% calling the service for urgent or emergency care);

•   Almost a third of respondents said they were happy with the current GP out of hours service;

•   Almost two thirds provided comments and suggestions for improvements;

•   Inappropriate use centred around complaining or for reasons other than urgent health care or advice;

•   Just a tenth of respondents called 111 in connection with a long term health condition.  This suggests that the majority of long-term condition patients are receiving primary care or community support, or are able to manage their own health;

•   GP surgeries and pharmacies score very highly for quality of service;

•   However, a relatively high number of people were unaware of NHS Choices website as a source of valuable patient information, or of the existence of an urgent GP service;

•   Over two thirds said they would use NHS Choices for health advice;

•   Reassuringly, no-one said they would contact A&E or 999 for health advice;

•   Over 90% of people said that being able to speak to a nurse or healthcare professional was very important;

•   83% said that receiving a telephone call within 15 minutes of making contact with the service was very important.  People are very keen to have greater clinical input at the call-handling stage of both 111 and GP out of hours services;

•   There is a feeling that repetitive questions being asked by call handlers do not make sense;

•   A more localised service is highly preferred – not having to travel too far to an out of hours centre or to a hospital. Local knowledge of clinicians was seen as very important;

•   The ability to share information and keep the local GP informed, or have access to patient records was a key issue;

•   Nurse-led local centres, referrals to emergency dentists and talking to a nurse rather than a non-clinical call handler were key suggestions for improvement.

 Next steps

Digital outreach to share emerging developments and receiving specific comments in a timely fashion (web and social media broadcast).  This will enable us to continue with our ongoing attempts to reach specific groups with equality needs.

This communication and engagement channel will be the conduit through which commissioning decisions can continue to be influenced in as timely a manner as possible.


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