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Integrated Urgent Care Service Specification Integrated Urgent Care Service Specification NHS England INFORMATION READER BOX Directorate Medical Operations and Information Specialised Commissioning Nursing Trans. & Corp. Ops. Strategy & Innovation Finance Publications Gateway Reference: 07092 Document Purpose Policy Document Name Integrated Urgent Care Service Specification Author Integrated Urgent Care Delivery Team Publication Date 25 August 2017 Target Audience CCG Clinical Leaders, CCG Accountable Officers Additional Circulation NHS England Regional Directors, NHS England Directors of List Commissioning Operations Description 0 Cross Reference Integrated Urent Care Comissioning Standards Superseded Docs 0 (if applicable) Action Required 0 Timing / Deadlines By 00 January 1900 (if applicable) Contact Details for Integrated Urgent Care Delivery Team further information 4N04 Quarry House Leeds LS2 7UE 0113 824 9506 [email protected] 0 Document Status This is a controlled document. Whilst this document may be printed, the electronic version posted on the intranet is the controlled copy. Any printed copies of this document are not controlled. As a controlled document, this document should not be saved onto local or network drives but should always be accessed from the intranet. Document number: 1 Issue/approval date: 25/08/2017 Version number: V_0.23a Status: approved Next review date: dd/mm/yyyy Page 2 Integrated Urgent Care Service Specification Version number: V_0.23a First published: Prepared by: Integrated urgent care delivery team This information can be made available in alternative formats, such as easy read or large print, and may be available in alternative languages, upon request. Please contact 0300 311 22 33 or email [email protected] stating that this document is owned by the Integrated Urgent Care Delivery Team, Operations and Information Directorate. Document number: 1 Issue/approval date: 25/08/2017 Version number: V_0.23a Status: approved Next review date: dd/mm/yyyy Page 3 Contents Executive Summary ................................................................................................. 11 1.1. Introduction ................................................................................................. 11 1.2. Key elements of an Integrated Urgent Care Service - Action required by all NHS 111 and OOH commissioners ...................................................................... 12 1.3. The Clinical Assessment Service – present and future ............................... 12 1.4. Technology.................................................................................................. 14 1.5. Clinical Governance .................................................................................... 15 1.6. Delivery Targets .......................................................................................... 15 1.7. Developing a Lead Commissioner Arrangement ......................................... 16 1.8. Developing a Collaborative Provider Arrangement ..................................... 16 2. Service Specification ......................................................................................... 18 2.1. Introduction ................................................................................................. 18 3. National/Local Context and Evidence Base ....................................................... 20 4. Outcomes .......................................................................................................... 22 4.1. NHS Outcomes Framework Domains & Indicators ..................................... 22 4.2. Locally Defined Outcomes .......................................................................... 23 5. Scope ................................................................................................................ 24 5.1. Aims and Objectives of Service ................................................................... 27 5.2. Service Description/Care Pathway .............................................................. 27 5.3. Access and Hours of Operation .................................................................. 27 5.3.1. Access Channels .................................................................................. 27 5.3.2. Mapping Service Boundaries ................................................................ 27 5.3.3. Opening Hours ..................................................................................... 28 5.3.4. Population Covered .............................................................................. 28 5.3.5. Clinical Assessment, Diagnosis and Advice ......................................... 28 5.3.6. Face-to-Face Consultation and Treatment ........................................... 29 5.3.7. Home Visits .......................................................................................... 30 5.4. Operating Model–111 Call Handling ........................................................... 31 5.4.1. NHS 111 Call Handling Process ........................................................... 32 5.5. Operating Model – Clinical Assessment Service ......................................... 41 5.5.1. Appointment Booking ........................................................................... 41 Document number: 1 Issue/approval date: 25/08/2017 Version number: V_0.23a Status: approved Next review date: dd/mm/yyyy Page 4 5.5.2. Streaming ............................................................................................. 42 5.5.3. Low Acuity Ambulance Validation ......................................................... 42 5.6. Clinical Decision Support System (CDSS)/Clinical Triage and Assessment 44 5.6.1. Operational Principles........................................................................... 44 5.6.2. Role Based Workflow ........................................................................... 44 5.6.3. Commissioning and Procurement of CDSS .......................................... 46 5.6.4. Safety Standards .................................................................................. 46 5.6.5. Governance .......................................................................................... 46 5.7. Service Directory & Capacity Management ................................................. 46 5.8. Workforce .................................................................................................... 49 5.8.1. Introduction and Underlying Principles ................................................. 49 5.8.2. Non-clinical Telephone/Remote Workforce .......................................... 50 5.8.3. Clinical Telephone/Remote Workforce ................................................. 50 5.8.4. Mental Health and Wellbeing ................................................................ 51 5.8.5. IUC Clinical Assessment Service (CAS) workforce .............................. 51 5.8.6. IUC CAS / NHS 111 Workforce Blueprint ............................................. 53 5.8.7. Recruitment, Retention and Vacancies ................................................ 53 5.8.8. Medicines and Poisons training ............................................................ 53 5.8.9. Other Specialist Training ...................................................................... 54 5.9. Interoperability ............................................................................................. 54 5.9.1. Referrals and Transfers (covering Sending, Receiving, Content, and Endpoints) ......................................................................................................... 54 5.9.2. Transferring/Referring Patients between Services ............................... 54 5.9.3. Directory of Services ............................................................................ 55 5.9.4. Appointment Booking ........................................................................... 55 5.9.5. Ambulance Requests ........................................................................... 55 5.9.6. Continuation of Triage .......................................................................... 55 5.9.7. Repeat Caller Service (RCS) ................................................................ 56 5.9.8. Post Event Messaging .......................................................................... 57 5.9.9. Online/Digital Services.......................................................................... 57 5.10. Telephony & IT Systems .......................................................................... 57 5.10.1. The Function of the National 111 Telephony Platform ...................... 57 5.10.2. Hosting and charge reversal ............................................................. 57 Document number: 1 Issue/approval date: 25/08/2017 Version number: V_0.23a Status: approved Next review date: dd/mm/yyyy Page 5 5.10.3. Other users of 111 ............................................................................. 58 5.10.4. Location based routing ...................................................................... 58 5.10.5. Location Unknown Calls .................................................................... 59 5.10.6. Call Steering - Interactive Voice Response (IVR) .............................. 59 5.10.7. Resilience .......................................................................................... 59 5.10.8. National Contingency ........................................................................ 59 5.10.9. Maintenance of The 111 Carrier’s Platform ......................................
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