Meeting the urgent care challenge
We provide more GP out of hours and NHS 111 services than any other provider in England.
Addressing urgent care needs, particularly when GP practices are closed, without increasing pressure on emergency and acute services, remains a key challenge for commissioners and providers. But the successful development of new, more integrated services, enabling patients to access clinicians directly with less need for call backs, offers scope to innovate further and improve both the access to and experience of urgent care across England.
NHS 111 – developing a high quality team
Mobilising the NHS 111 service meant a sustained long term programme to build capacity to deal with a rising overall level of demand, and to ensure that the NHS Pathways model of telephone triage and support made best use of ambulance and emergency services without creating inappropriate and uneconomic dispositions and admissions.
When out of hours provider Harmoni became part of Care UK prior to the launch of the NHS 111 service, our specialist teams, set about an extensive programme of consultation, research and innovation to create the resilient and effective infrastructure to serve around 15 percent of England’s population.
In the first half of 2014 our call centres answered an average of 207,623 calls a month. 95 percent of those calls were answered within 60 Seconds. Our training team has successfully met the challenge of training more than a thousand health advisors and clinical advisors in NHS Pathways, the decision-making programme used to provide the service.
Health adviser training lasts four weeks, with an additional six weeks needed for the service embedding that gives our handlers and callers the confidence they need in the service. Despite logistical challenges and the rigorous requirements set by NHS Pathways and recruitment issues, we successfully trained and mobilised all NHS 111 staff prior to the launch date. In addition we trained more than 180 advisers who were taken on to deal with the larger than expected demand for the service.
A particular challenge for our team is meeting the ongoing training requirement while ensuring operational staffing rotas are maintained and service requirements met. Urgent care services operate 24/7, requiring
colleagues to work non-standard hours and needing training to be accessible anytime, anywhere – allowing colleagues to train in line with their existing shifts and commitments.
The Care UK Academy of Excellence was created to embed an ongoing learning and workforce management approach to support the quality delivery of urgent care. Our rigorous Learning Management System (LMS) allows employees to own, manage and implement their own training by removing the difficulties of training time and operational rota requirements.
Colleagues are able to attend the appropriate training sessions after a work form management tool has assigned training slots to fit existing rotas. This maximises the employee’s time as training is allocated during periods of over-staffing or low call volumes. Training modules can be delivered anytime, anywhere, through a wide range of media including Android tablets, iPads and smartphones. Content is interactive, engaging and an active part of every colleague’s working day.
To identify individuals’ training needs and ensure a highly performing service, regular call and performance reports are monitored and a skills matrix links competencies to training interventions such as e-Learning, face-to-face coaching and external courses, allowing the service manager to select appropriate training and use the Care UK Academy of Excellence LMS to book this in the employee’s rota. The system tracks performance during the training and reports in real time to participants and managers.
Investment in a structured and accessible training and development tool has been a critical factor in assuring commissioners of the ongoing quality of our urgent care services.
The result of our team’s commitment to creating an excellent service is clear. Our regular surveys show a high degree of customer satisfaction. In London, for example, more than nine out of 10 of patients, surveyed after calling our 111 services, would recommend the service to a friend.
Our urgent care statistics:
- 80 Advanced Nurse Practitioners (ANPs)
- 900 GPs, all of whom are on NHS performers lists
- 1,200 clinical experts employed in our urgent care services
- 185,000 NHS 111 calls handled each month
- 450,000 patients receive a face-to-face consultation outside normal GP practice opening hours