Urgent or unplanned care consumes more than half the cost of the NHS, and represents about a third of the overall activity within it. This practical guide for commissioners builds on thinking emerging from reviews and innovative work by the Primary Care Foundation for the Department of Health over recent years. Without proposing a blueprint the authors seek to capture some of the insights gained on different aspects of urgent care:
The aim here is to distil the evidence from our work, highlighting what has been shown to work, as well as debunking myths.
The contents span:
- Principles for commissioning urgent care
- The seven myths of urgent care
- The evidence: what we know
- Commissioning the whole system: why the big picture matters
- Improving the commissioning of individual services
- Towards an integrated care system
- What do providers think makes a good commissioner of urgent care
- A specification checklist for an urgent care service
Chapter 6 summarises the evidence-base and the authors signpost readers to published evidence, including Avoiding hospital admissions: what does the research evidence say?, King’s Fund, 2010.
The heart of the work lies in the presentation of 8 case studies. Covering the work of urgent care commissioners around different parts of England over the past five years, These examples are not presented as best practice. Rather the goal is to accelerate the learning process of those new to the issues so that others might avoid repeating mistakes in the future.
The examples focus on specific aspects of commissioning – such as developing strong commissioner-provider relationships, addressing the needs of those in care homes – and themes around preventing emergency admissions and using data.
Chapter 9 brings the paper to a close with a specification checklist for an urgent care service.
A specification for individual parts of the service should be specific enough to ensure the service is delivered, but not in so much detail as to destroy innovation or indeed prevent providers Implementing efficiencies.
Breaking the Mould Without Breaking the System: New Ideas and Resources for Clinical Commissioners on the Journey Towards Integrated 24/7 Urgent Care
By David Carson et al, NHS Alliance, Primary Care Foundation, November 2011