Urgent Care Services

What is urgent care?

The official definition of urgent care is any form of medical care delivered on an outpatient basis. In this case urgent care describes medical conditions which do not require hospital admission and can be managed without a trip to an emergency department. Instead the patient could be treated using local community services or out-of-hospital facilities.

The purpose of the NWAS Urgent Care Strategy is to help us to better manage our resources and increase our ability to direct patients to the most appropriate pathway of care.

The strategy will increase the number of 999 calls that can be resolved without a physical ambulance response, enabling us to have our resources available to get to those patients with life threatening conditions.

How does it work?

When a 999 call comes in to one of the Trust's control rooms the call-taker will use a set of structured questions and answers to assess the severity of the symptoms and the level of response required. Many patients will continue to receive an ambulance response, however some patients can be referred to either the Urgent Care Desk or NHS Direct for clinical assessment by telephone. This helps us to determine the most appropriate care pathway for the patient by selecting primary care or alternative providers more suitable than a traditional Emergency Department.

Senior Paramedics on the Urgent Care Desk performing secondary triage have access to libraries of alternative healthcare providers including the CMS Directory of Services. This is a real-time, 24 hour database of currently available clinical care services in the community. The database will produce a list of services that match the patient's need and display them to the clinician. The patient will then be referred to one of these services.

Clinicians performing secondary triage can also determine the requirement for Paramedic Emergency Service transport and will often seek to utilise alternatives such as non-emergency transport.
These triage tools allow clinicians to confidently determine the most appropriate destination for patients.

Paramedic Pathfinder

Paramedic Pathfinder is another element of the Urgent Care Strategy. Paramedics conduct a face to face assessment when they arrive at the scene and, using a flow chart of specific symptoms, determine the most appropriate care pathway for that patient.  Depending on the assessment, the next step for the patient could be that they are taken to either a community based specialist service, an Urgent Care Centre or to an Emergency Department. If they are not in need of medical treatment, they will instead be instructed on any self-care they may need.

111 Service

NHS 111 is a non-emergency number for accessing local health services. The service acts as a single point of access for urgent care. It seeks to improve and simplify access to non-emergency health care by providing a memorable three-digit telephone number that is free to the caller. The caller will be triaged using a clinical call handling system (NHS Pathways) and the patient is subsequently signposted to a local service using a local 'Directory of Services' to most appropriately meet their need.

In the North West a pilot is currently running to deliver 111 in Lancashire. The pilot is a partnership between NHS Direct, GP out-of-hours provider Fylde Coast Medical Services (FCMS) and NWAS and is part of the Trust's Urgent Care Strategy. The remainder of the North West is due to go live by April 2013, following a tendering and procurement process.