Bristol Team - BAAEC Conference 131015
Transcription
Bristol Team - BAAEC Conference 131015
Ambulatory Care – Bristol Royal Infirmary UHB in Partnership with BrisDoc - The Primary – Secondary Care Interface Emma Kinnaird – Lead Nurse, Ambulatory Care, UHB Paul Davies – Clinical Lead, GP Support Unit Ambulatory Care History - Bristol UHBristol BrisDoc • 2003 BrisDoc Formed Thrombosis Service • 2008 GPSU Created TIA clinic • 2013 Joint contract (with Pathology Day Unit UHB) awarded Multiple initiatives across site eg ‘Hot Clinics’ • ACU 2012 • • • • Ambulatory Care Unit 2012- Partnership • Brisdoc awarded the contract for GPSU at BRI through strategic alliance with UHB – 8am to 8pm M-F • Provide medical advice to Health Care Professionals 24/7 (via OOH + GPSU using ‘Professional Line’) • Interface between the local community Bristol GPs and medical admissions team at BRI • Based on delivering a local and personal service, innovation, flexibility, team working, trust and communication • Contract includes Funding for Hospital Physician input to ‘Primary Care’ (GPSU) patients Ambulatory Care Model for UHBristol Incorporating GPSU Totality of Ambulatory Care in UHBristol GPSU Primary Care Call Handling GPSU in Hospital TIA Hot Clinic Ambulatory Care Unit Other STAU Informal Consultations MAU Obs Unit DVT PDU Where we are now • Physical location within Bristol Royal Infirmary • Open 8am-8pm Monday to Friday • Co-location of GPSU / Thrombosis / medical take teams and PDU all working in partnership in ACU • Established cross-organisational multi-professional team • 21 pathways on trust intranet • Executive support • Performance measurement and ACU data report • Patient satisfaction feedback is positive GPSU Performance • In addition to trust developments simultaneously GPSU impact growing in alternatives to admission • In 2014/15 GPSU took 7648 calls from Community Healthcare Professionals (5566 GP calls) and passed 2615 of these patients to the AMU (and admitted 296 to other inpatient areas) • GPSU saw 3167 patients face to face, admitting 406 (13%) of these. • Information flow from secondary to primary care (eg cellulitis pathway, hot clinics) • Similar unit being developed in North Bristol 2015 Next steps • New 7 day service supported by 7 day nursing and medical model (from October 2014) • Continue pathway development based on data analysis • Develop Joint Governance Framework for GPSU and UHB in Ambulatory Care • Review Performance data, feedback and audit to support service development • ?Acute Physician Model from early 2016 – likely to influence model • ?Opportunities for Training posts in Ambulatory Care Challenges • • • • • • • • • • Greater integration (core training and competences) Commissioner agenda & financial implications Role recognition, recruitment, indemnity & governance Primary care delegation of responsibility? Managing Frailty in ambulatory care Politics and geography (CCGs) Maintaining consistency in clinical management 2 tier system (ED vs GP admissions) Information Technology Ambulance and ED interface Any Questions?