We are developing our approach to assessing and reporting on the quality of urgent and emergency care and our wider strategy on integrated care, care pathways and place-based care.
This is aimed at supporting improvement in urgent and emergency care to give a seamless journey and positive experience for patients. We are exploring how we can assess quality across a local area, by looking at how well providers work together within a local system.
To help us do this, we tested an approach that looked at how care is coordinated between different types of care providers in a local area. We worked with local and national stakeholders to pilot our approach in two areas or ‘localities’.
Our pilot reports
We piloted our approach in two localities:
- Airedale, Wharfedale, Craven and Bradford (Bradford & Airedale SRG)
- South Warwickshire (South Warwickshire SRG)
We looked at the contribution of all services that support people who need urgent and/or emergency care (including NHS 111, A&E departments, ambulance services, GP out-of-hours services, walk-in centres, and GP practices).
We have published a report for each locality about what we found from testing our method. These reports look at how care is coordinated between, and within, care providers. The reports do not reflect any regulatory judgements by CQC. The reports are based on a combination of our findings from fieldwork conducted with a limited sample of local services, patient case tracking and interviews, and discussion groups with people who use and run services. Due to the limited sample of services involved in our pilot fieldwork, the reports do not provide a definitive picture of local performance.
The quality of urgent and emergency care in Airedale, Wharfedale, Craven and Bradford
The quality of urgent and emergency care in South Warwickshire
Alongside the findings reports we have published a locality data profile report, which comprises performance data about local providers.
Please note: this was produced primarily to support the fieldwork teams. The data used reflects what was available at the time of writing and as such it is not an up-to-date picture of performance or activity.
What did this pilot assessment look at?
- People’s experiences of urgent and emergency care and clinical outcomes of care
- How the different parts of the urgent and emergency care system coordinate care locally and how they communicate together
- The efficiency and effectiveness of the system (do people receive the right care at the right time?)
How did we carry out the work?
We gathered information both during and before the visit to each locality from members of the SRGs, for example:
- local commissioners and local authorities
- local Healthwatch or similar patient and public groups
- acute hospitals, urgent care centres, ambulance
- GP practices,GP out-of-hours services, and NHS 111 services.
We considered how the urgent and emergency care system is organised and led through the SRG to ensure that it is of high quality and well-coordinated.
We met and spoke with people who had used urgent and emergency care services. We followed their journey through the urgent and emergency system, from initial contact onwards. To help us understand people’s experience as they move through urgent and emergency care services, we followed the journey of two patient groups:
- people aged over 65 who have had a fall that has resulted in harm
- children under the age of five with feverish symptoms.
We also talked to local people about their experiences of urgent and emergency care to ensure that we captured the experiences of different groups.
What happens next?
In line with our 2016-21 strategy, we are evaluating the approach and will make recommendations on how we can include the learning from the pilot approach into our future inspections of urgent and emergency care as part of our overall approach to integrated care.
About coordinated care: code snippet for IPP pages
Coordinated care: integration, pathways and place
Our work on coordinated care looks at the way services work together to make sure people's care meets their individual needs. Read more...