A new model for Urgent Care for NW London?

If you want urgent (unplanned) medical help where do you turn to – your GP, A&E, a Walk In Centre , an Urgent Care Centre,  Minor Injuries Unit, or Out of Hours GP service, ring 999 or 111 ? In hours and Out of Hours the choices are rather different. This multiplicity of choices and the different options in each area makes for a very confusing picture and it is no wonder people often go to less appropriate places.

There is a lot of duplication and very poor communication so that you have to repeat your story and there no access to your complete medical record held at your GP practice and the information about your urgent care contact may not filter back to the GP or other people involved in your ongoing care. You may be seen by a doctor or a nurse or another type of professional. And the cost is high; attendance at A&E is rising inexorably and you’ll have seen the headlines showing that the system is breaking and unsustainable in its present form.

We need a system that is much clearer and less confusing, quicker and more responsive, able to share information when needed and joined up with all other bits of the health and social care systems, breaking down the artificial organisational barriers that inhibit good quality, efficient care.

But how to do this and within a shrinking budget? The service providers do not know all the answers and look to users of the system to help set the agenda and shape the future. 19 separate events have taken place across NW London to gain insights into what the public would like to see.

Some small scale but important changes have already happened. But some bigger changes are planned, for instance the proposed creation of a Clinical Advice and Treatment Service (CATS)  set up within or alongside 111 to give better triage and quicker advice and treatment options from a wider variety of professionals including doctors, pharmacists, nurses  and social workers (111 is currently mainly a call handling service with limited clinical support from nurses and paramedics relying on computer decision making tools).

All this is hugely complex and will require great cooperation and ‘ownership’ across  all the different agencies, much better technology and systems and a wider skill mix involved in providing the service and of course it will cost a lot to set up before it makes any savings, if indeed it ever does.

To see what’s going on and get involved if you want to, please look at some of the documentation from a recent event held in Brent on 14th June, available here