Out-of-hours care in western countries: assessment of different organizational models

Source: BMC Health Services Research 2009, 9:105

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Date of publication: June 2009

Publication type: Journal article

In a nutshell: Internationally, different organizational models are used for providing out-of-hours care. This study used a survey across 25 countries to assess prevailing models and identify their potential strengths and weaknesses.   In most countries several different models existed alongside each other, including Accident & Emergency, rota groups and GP cooperatives.  The perceived strengths and weaknesses of these models are discussed.  GP cooperatives combine size of scale advantages with high accessibility, continuity and coordination of care. While specific patients require other organizational models, the co-existence of different models for out-of-hours care in a country may be less efficient for health systems.

Length of publication: 21 pages

An evaluation of the accuracy and safety of NHS Pathways

Source: Parliament 

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Date of Publication: June 2008 (published online June 2009)

Publication Type: Research

In a nutshell: Report that assesses the robustness, performance, accuracy, efficiency and safety of the NHS Pathways trial with North East Ambulance Service. NHS Pathways refers callers to the Ambulance service to relevant alternative care providers if appropriate, reducing the number of Category A (8 minute response calls). The report concluded that NHS Pathways was at least as safe as current call assessment and prioritisation processes. The study informed the Department of Health’s decision to allow Ambulance services across the UK to adopt NHS Pathways, announced in the February 2009.

Length of publication: 130 pages

Some important notes: E-Health Insider reports the original announcement from The Department of Health on NHS Pathways.

Acknowledgements: Turner , J., Lattimer, V. and Snooks, H., 2008. An evaluation of the accuracy and safety of NHS Pathways. London: Commissioned by The Department of Health from The Medical Care Research Unit at the University of Sheffield in collaboration with the University of Southampton and Swansea University.

Urgent care project: best practice review

Source: Warwick Medical School

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Date of Publication: February 2009

Publication Type: Best Practice

In a nutshell: Review aimed at creating an evidence base for the design of a new vertically integrated urgent care system. An extensive review of the literature looking at UK and international examples organises results into: 1) the way care is organised, 2) specific ways of providing care and 3) involving people in their care.  The review identifies initiatives that may reduce unplanned hospitalisation and re-addmission, interventions that may reduce hospital stays and interventions that may moderate readdmission.

Length of Publication: 35 pages

Pandemic flu: managing demand and capacity in health care organisations (surge)

Source: Department of Health  

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Date of publication: May 2009

Publication type: Best Practice

In a nutshell: The aim of this guidance is to support NHS and social care organisations to build on their existing preparedness plans and enable clinicians to work within an ethical framework during a pandemic, when there may be a significant increase in demand for care. It contains guidance for primary and secondary care services on managing demand and capacity and the prioritisation of services and patients during an influenza pandemic

This document provides staff with guidance on operational issues around the increase in demand for services, and supporting clinicians with the decision making processes on triaging patients.

Length of publication: 127 pages

Some important notes: This guidance should be used to inform current planning during World Health Organisation (WHO) Phase 3 and to assist in the development of pandemic preparedness plans. It is intended for operational use in the UK once WHO declares Phase 6 and the Department of Health in England (as the UK lead agency for pandemic influenza) declares UK alert level 1.

Commissioning a new delivery model for unscheduled care in London

Source: Healthcare for London

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Date of publication: 2008

Publication type: NHS Trust document

In a nutshell: This document provides guidance for PCTs to support the development of unscheduled care commissioning and commissioning strategic plans (CSPs). It sets out a new delivery model for unscheduled care in London based on a tiered approach which encompasses three broad responses to patients’ unscheduled care needs – rapid/moderate; urgent; and emergency.

Length of publication: 28 pages