WEST YORKSHIRE TO LEAD NHS INTO NEW ERA OF URGENT CARE

NHS England Chief Executive Simon Stevens and the NHS Five Year Forward View partners have announced  eight new vanguards that will launch the transformation of urgent and emergency care for more than nine million people.

The announcement includes the West Yorkshire Urgent and Emergency Care Network that will oversee, with local partners, the improvement of urgent care for more than three million people in West Yorkshire.

This comes as NHS England also revealed the success of Regional Major Trauma Networks which, after they were set up just three years ago, have seen a remarkable 50 per cent increase in the odds of survival for trauma patients revealed in a new independent audit by the Trauma Audit and Research Network(TARN).

Building on the recent success in improving trauma survival rates, the urgent and emergency care vanguards are tasked with changing the way in which all organisations work together to provide care in a more joined up way for patients.

Urgent care is delivered not only in hospitals but by GPs, pharmacists, community teams, ambulance services, NHS 111, social care and others, and through patients being given support and education to manage their own conditions. A key aim of the vanguards is to not only improve the access and delivery of these services but to break down boundaries between physical and mental health services to improve the quality of care and experience for all.

The eight new vanguards will spearhead this work and, like other vanguards, will benefit from a programme of support and investment from the £200m transformation fund.

Six vanguards will cover smaller local systems which may include hospitals and surrounding GP practices and social care, while two network vanguards will be working with much larger populations to integrate care on a greater scale.

In West Yorkshire, the Network's partners want to build on local transformational plans to go further and faster. There will be a particular focus on ambulance services - building on current expertise and recognising that the service is about mobile treatment at home as well as patient transport. The Network will also focus on mental health services to improve and strengthen crisis response, as the needs of these patients impact across the entire urgent and emergency care system including social services and the police.

NHS England's Chief Executive, Simon Stevens,said:

"Starting today, the NHS will begin joining up the often confusing array of A&E, GP out of hours, minor injuries clinics, ambulance services and 111 so that patients know where they can get urgent help easily and effortlessly, 7 days a week. That's why we're backing what our frontline nurses, doctors and other staff, in partnership with local communities, to radically redesign our urgent and emergency services."

Chris Dowse, Chief Officer, NHS North Kirklees Clinical Commissioning Group and Chair of the West Yorkshire Urgent and Emergency Care Networksaid:

"It is fantastic news that the West Yorkshire Urgent and Emergency Care Network has been chosen as a vanguard site for Urgent and Emergency Care.  We want to use this opportunity to build on what we have been doing for the last year and inject more pace and scale into it. I am also delighted that our partners from Yorkshire Ambulance Service will be working with us to increase the pace of change which will see our ambulance services recognised by patients as a mobile treatment service rather than just a means of transporting them to hospital for emergency care.

We will be building on an existing programme of work through the Mental Health Crisis Concordat to improve crisis response. Knowing that these patients, when in crisis, touch all points of our urgent and emergency care system including social services and the police, we must get our services right for them."

Chief Executive Steven Michael OBE at South West Yorkshire Partnership NHS Foundation Trustsaid:

"We know that many people experiencing a mental health crisis end up being cared for far away from home - and that their outcomes are often worse because of this. Working in partnership with the police, ambulance service and wider NHS, we are delighted to be part of this vanguard programme. It will help us to address the issue locally, delivering more effective care that will benefit people who are in a mental health crisis."

Dr Philip Foster, Associate Medical Director of NHS 111 and Urgent Care Services at Yorkshire Ambulance Service NHS Trust, said:

"We are delighted that the application put forward by the West Yorkshire Urgent and Emergency Care Network has been successful in securing Vanguard status.

As the regional provider of the emergency ambulance and NHS 111 urgent care services, we are well placed to help join up the separate elements of care for the benefit of patients and this will encompass the work of our NHS partners, social care colleagues and the police.

Yorkshire Ambulance Service is committed to the partnership work required to further develop our region's urgent and emergency care services and take forward some of the pilots already completed."

The launch of the vanguards comes in the face of pressure on all NHS frontline emergency services, with increased A&E attendances and emergency admissions, and both ambulance and NHS 111 services facing rising demands.

The Urgent and Emergency Care vanguards are a key element within the NHS Five Year Forward View which is a partnership between NHS England, the Care Quality Commission, Health Education England, Monitor, the Trust Development Authority, Public Health England and the National Institute for Health and Care Excellence and represent the next step in the transformation of Urgent and Emergency Care for the NHS announced by Sir Bruce Keogh, NHS England's National Medical Director, in 2013.

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Notes to editors:

West Yorkshire Urgent Emergency Care Network

Established in 2014, the West Yorkshire Urgent and Emergency Care Network Vanguard covers Leeds, Bradford, Airedale and Craven, Calderdale, Kirklees, Wakefield and Harrogate. It serves a population of around three million people. The Vanguard will work with partners, including five local System Resilience Groups, to build on progress already made in transforming primary, community and acute care services.

Yorkshire Ambulance Service will develop a stronger focus on becoming a mobile treatment service delivering care at patients' homes with conveyance to hospital for those who really need to go.  

Three mental health service providers will work with West Yorkshire Police to deliver major service change which will see rapid crisis response through emergency response control centres and ‘street triage'.  

Other planned projects include creating an Integrated West Yorkshire Care Record and a system-wide information dashboard which reports in ‘real-time'.

Statistics showing the increasing pressures on Urgent and Emergency Care:

Demands on A&E soar over the past decade:

  • There were 22.4million A&E attendances last year - 600,000 more than in 2013-14.

  • Attendances are 1,852,000 or 9% higher than 5 years ago (2009-10) when there were 20,512,000 attendances.

  • The growth in A&E attendances on 10 years ago (2004-05, when the total was 17,837,000) is up 4,527,000 or 25%.

  • There was a total of 5,483,000 emergency admissions 2014-15 - that is 210,000 MORE than in 2013-14.

  • Emergency admissions for 2014-15 are up 392,000 or 8% on the total of 5,091,000 in 2011-12

Ambulances face rising demands:

  • The number of calls where a Category A ambulance arrived at the scene has increased 25%between 2011.12 and 2014/15

  • The highest number of calls per day, 9,779, was recorded in December 2014 - more than in any other month, since this series began in 2011.

  • Calls per day where a Category A ambulance arrived at the scene were:

6,856 in 2011-12

7,431 in 2012-13

7,847 in 2013-14

8,576 in 2014-15

NHS 111 service under increased pressure:

  • NHS 111 received 4.1million MORE calls than in 2013-14. In 2014-15 it handled more than 12million calls and this is expected to rise to around 16million this year.

  • NHS 111 dealt with 4.6 million calls this winter (2014/15 Nov-Feb) - around one million or 27% up on the 3.6m calls handled for the same period last winter.

  • In handling 12 million calls, NHS 111 offered treatment to over two million people who would otherwise have visited A&E, and another 600,000 who would have dialled 999 for an ambulance, reducing a significant amount of unnecessary pressure on our urgent care services.

  • The latest NHS 111 follow-up surveys, for the year ending September 2014, show that 30% of callers would have gone to A&E, and 17% would have contacted the 999 ambulance service, had NHS 111 not been available. Of actual NHS 111 calls over the same year, 8% were recommended to attend A&E, and 11% had an ambulance dispatch.

  • The total number of calls offered to NHS 111 in England:

2010/11:     187,630

2011/12:     616,155

2012/13:   1,894,057

2013/14:   8,785,341

2014/15: 12,880,769

  • 2014/15 had 47% more calls than 2013/14 as the NHS 111 service was gradually rolled out across England, reaching completion in February 2014. 

  • April 2015 (1,130,894 calls) was 5% more than April 2014 (1,080,893), and May 2015 (1,184,177) was 6% more than May 2014 (1,112,633).