London acute neurology services: A case for change

This document describes why neurological services must change how patients are managed upon entering the health system through emergency and urgent care routes.

London acute neurology services: A case for change
London Clinical Networks
January 2015

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Alcohol Care Teams: to reduce acute hospital admissions and improve quality of care

"The principal component of this initiative is for a multidisciplinary Alcohol care team in each district hospital, led by a consultant with designated sessions, who will collaborate across hospitals and primary care, to develop a coordinated alcohol treatment and prevention programme. This team would organise systematic interventions and alcohol specialist nurses."

Alcohol Care Teams: to reduce acute hospital admissions and improve quality of care (Quality and Productivity case study)
The British Society of Gastroenterology and the Royal Bolton Hospital NHS Foundation Trust
NICE
March 2016

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Emergency Care Improvement Programme

"The Emergency Care Improvement Programme will focus on helping 28 urgent and emergency care systems across England that are under the most pressure and will deliver real improvements in quality, safety and patient flow."

Access improvement tools, videos and more at the NHS Emergency Care Improvement Programme website.

Improving emergency department flow through Rapid Medical Evaluation unit

"By specifically re-purposing a fraction of existing staff, resources, and infrastructure for patients with lower acuity presentations, we were able to streamline their care and decrease wait times in the ED"

Improving emergency department flow through Rapid Medical Evaluation unit
L Chartier, T Josephson, K Bates, M Kuipers
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206156.w2663

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Barriers to implementation of a redesign of information transfer and feedback in acute care

"Accurate communication is an important feature of seamless care and enhances patient safety. Information transfer and patient handovers are noted to be potentially hazardous areas for error in emergency care."

Barriers to implementation of a redesign of information transfer and feedback in acute care: results from a multiple case study
JE van Leijen-Zeelenberg, AJA van Raak, IGP Duimel-Peeters, MEAL Kroese, PRG Brink, D Ruwaard, HJM Vrijhoef
BMC Health Services Research, 2014, 14: 149

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Whole-system solutions for urgent and emergency care

"Demand for urgent and emergency care continues to increase year on year and it has been evident for some time that the system for delivering this care must adapt to meet ongoing and new challenges."

Ripping off the sticking plaster: Whole-system solutions for urgent and emergency care
Urgent and Emergency Care Forum
NHS Confederation
March 2014

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NHS payment reform: lessons from the past and directions for the future

"To ensure that the long-term reforms to the payment system support the NHS to deliver efficient, high-quality care, Monitor and NHS England need to develop an approach that is:

• Comprehensive.
• Focused
• Aligned with wider system changes
• Transparent and evidence-based
• Predictable and credible"

NHS payment reform: lessons from the past and directions for the future
A Charlesworth, L Hawkins, L Marshall
Nuffield Trust
February 2014

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The role of charging in healthcare

"There is growing evidence that the NHS is facing a funding challenge as demand grows and the level of funding available declines."

The cost of our health: the role of charging in healthcare
T Cawston, C Corrie
Reform
November 2013

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Stretched to the limit: a survey of emergency medicine consultants in the UK

"This report, the first of its kind, describes the working practices of consultants and other senior decision makers in the Emergency Department (ED), the pressures they face and the impact on their working lives."

Stretched to the limit: a survey of emergency medicine consultants in the UK
TB Hassan, B Walker, M Harrison, F Rae
The College of Emergency Medicine
October 2013

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Urgent and emergency services

"Growing demand on A&E departments will make them unsustainable if effective action is not taken quickly to relieve the pressures on them."

Urgent and emergency services
House of Commons Health Committee
July 2013

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Urgent care centres: what works best?

"This paper offers some key thinking points for clinical commissioners to consider as they develop their plans for integrated, 24/7 urgent and emergency care."

Urgent care centres: what works best?
Primary Care Foundation
October 2012

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Getting to grips with integrated 24/7 emergency and urgent care

"This report considers the challenges and opportunities facing urgent care commissioners as they strive to develop an integrated 24/7 service while also introducing NHS 111."

Getting to grips with integrated 24/7 emergency and urgent care
NHS Alliance
October 2012

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How does lean work in emergency care?

"Improvements in waiting and lead times (19-24%) were achieved and sustained in the two years following lean-inspired changes to employee roles, staffing and scheduling, communication and coordination, expertise, workspace layout, and problem solving."

How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's Hospital, Stockholm, Sweden
P Mazzocato, RJ Holden, M Brommels, H Aronsson, U Backman, M Elg, J Thor
BMC Health Services Research, 2012, 12:28

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Effectiveness and safety of emergency department short stay units

"Limited evidence from 1 systematic review indicates that SSUs may lead to improved patient satisfaction in specific clinical contexts."

The effectiveness and safety of emergency department short stay units: a rapid review
KJ Konnyu, E Kwok, B Skidmore, D Moher
Open Medicine, 2012, 6(1):e10

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Emergency day surgery: Improving productivity and reducing bed days

"QIPP Evidence provides users with practical case studies that address the quality and productivity challenge in health and social care."

Emergency day surgery: Improving productivity and reducing bed days
NHS Evidence - Quality and Productivity: proposed case study
Whittington Hospital NHS Trust
January 2012

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How does lean work in emergency care?

"Improvements in waiting and lead times (19-24%) were achieved and sustained in the two years following lean-inspired changes to employee roles, staffing and scheduling, communication and coordination, expertise, workspace layout, and problem solving."

How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children’s Hospital, Stockholm, Sweden
P Mazzocato, RJ Holden, M Brommels, H Aronsson, U Backman, M Elg, J Thor
BMC Health Services Research, 2012, 12:28

Read more here.

Breaking the mould without breaking the system

"This resource is designed to offer ideas and inspiration to everyone responsible for commissioning urgent and emergency care in the UK, in particular, the new clinical commissioning groups in England."

Breaking the mould without breaking the system: new ideas and resources for clinical commissioners on the journey towards integrated 24/7 urgent care
D Carson, H Clay, R Stern
Primary care Foundation
November 2011

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