Urgent Care Transport

Urgent Care TransportInnovative Solutions – Supporting Commissioners

www.365response.co.uk

Dr Chris JonesIAA Annual ConferenceApril 2nd, 2014

The current problem

• Increasing demand & complexity• National variation in quality, efficiency and delivery• Increase in system redesign and impact on ambulance

activity• Unintended impact of 8 minute target for first 75 out of

100 people • Need to innovate whilst in the eye of the storm of

delivery• System impact of new commissioning landscape• Scale, costs and length of multiple procurements


What we set out to do

• Be clear on the problem to solve • Focus on a very small cohort of activity to test

innovation• Start with a blank sheet of paper• Clinically driven, experience led and • Designed from the view of the patient not to meet a

target


What is it?

• A clinically led – national standard for quality urgent care transport

• A fully procured, managed framework of accredited providers


An end to end service for professionals

• A localised response with a national quality standard• Creation of a different ‘front door’ • Ring-fenced ambulance capability that does not get

diverted • Focused on the needs of the patient group and

professionals• Fully procured, independently managed, totally

overseen


Same day GP Urgent

Mental healthtransport

End of life transfers

Inter-hospital& discharges

Out of contractECRs

PersonalBudgets

Renal patients

The framework explained

• Framework led and Hosted by NHS SBS • UK wide • Procured once, applicable everywhere • Broad base of CQC registered providers • Single, quality led specification and standards • Using the framework as a springboard for local

flexibility and best value• Standard NHS Contract between provider and CCG • Focus on Quality, Compassion and Innovation


Standards

• NHS England Compassion in Practice 6 C’s


Standards

• High standard of staff skills, experience and training• Mental Health Act and Code of Practice training• Care standards at pickup, in transit, handover• Vehicle standards• Differing mobility requirements• Booking process & notifications• Record keeping• Monitoring & reporting• Confidentiality and IG• KPIs• National Quality Standards• Safeguarding policies


Benefits for the patient

• Dedicated service booked by their referring clinician • Supporting different treatment pathways – ‘collect,

wait and return’• Condition specific transport that is personalised to

need • Reduction in delays • Earlier attendance at hospital or earlier discharge


Benefits for the commissioner

• Rapid access to pre established managed framework• Full market testing and price ceiling with minimum

savings identified • Platform to test and innovate for clinical areas and

service plans • Support for QIPP plans • No volume commitment• Reduced contact management overhead• Quality governance oversight from NHS WSYBCSU • Personalised, localised service


Benefits to providers• Accreditation against a national quality led standard for

urgent care transport: Apply once• Part of a fully procured process that will give you access

to a wide range of commissioners and providers • Opportunities to innovate and get new ideas to market • A fully managed service that helps to grow your services

for the benefit of patients • A market tested, compliant way to deliver services

reducing your costs of multiple tender responses • Provide services directly not as a subcontractor


Will it destabilise existing services?

No.• Optional• Aimed at growth or small cohort of activity• No patient access• Not PTS• Not 999• Designed to support where there are challenges• Should support emergency services• No need to decommission


Agents of change and innovation

• 365 are clinically led, social entrepreneurs • focused on creating innovation and impact for patients • Want to see the best of public and private sector

collaboration • Niche commissioning support in line with current

national thinking • Supports the gap in contract management and quality

oversight • Help to generate the conditions for testing new ways of

working


Our careful approach

• Start small, grow where needed • Support new pathway development • Use technology to drive our entire end to end service • Year 1 is about niche support, learning and

supporting • To be fully available when needed:

• Winter, system pressure, redesign, quality issues and cost pressures


Where we are now

• Framework is live• 30 lots across the UK• 42 providers signed up & keen to innovate• Official launch this week• 13 CCGs in pipeline with variety of needs• Available to support QIPP now with a focus on

Quality & Innovation


Our joint approach


Documents

Urgent Care Transport