Agenda item

This report outlines the background, performance, challenges, and future developments of the Dorset Integrated Urgent Care Service (DIUCS) to date. At the meeting there will be a presentation that will enhance this report.

The Head of Urgent and Emergency Care, NHS Dorset, presented a report accompanied by a presentation, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'A' to these Minutes in the Minute Book.

The report and presentation outlined the background, current performance and challenges and future developments of the Dorset Integrated Urgent Care Service (DIUCS) to date, including the operation of the NHS 111 First and NHS 111 Online services.

The Head of Urgent and Emergency Care responded to questions and comments on a number of issues, including:

• How to address the staff shortfall in clinical roles. This was a known national issue and recruitment was ongoing. At the moment other selected staff were being used to answer clinical assessment calls. This reflected a longer term approach to ensure a more multi-disciplinary workforce.
• Whether pay, terms and conditions were being looked at. The Workforce Team were checking that there were no discrepancies between services in terms of equal pay.
• How to deal with minor injury bookings. These were mostly managed in Emergency Departments but the Urgent Care project offer were looking at whether these could be dealt with in other ways.
• The Healthwatch representative asked how patient feedback was used to improve service. There were a range of ways including contract reviews, complaints, friends and family feedback, etc. It was also planned to engage with Healthwatch on the Out of Hospital project to better understand why people did not use 111 services more. The Healthwatch representative suggested that more publicity on improved response rates may help overcome previous negative experiences.
• Reasons for the increase in calls. This was partly attributed to better promotion of 111 and an increasing pressure on primary care. It was noted that where it would be beneficial to patients, they could be booked back into the primary care system.
• A Committee member commented on the reality of struggling to meet high demand and that people often did not ring again if their first call went unanswered. She endorsed the need for more publicity on recent improvements and more clarity on what the service was for. The Head of Urgent and Emergency Care acknowledged the points made and agreed they needed further work.
• How to assess if 111 First has improved patient experience. This was being evaluated as part of the urgent care project and there had been some positive feedback. Improvements were ongoing, Healthwatch was engaged and the importance of listening to people to ensure equitable service was noted.
• How to promote 111 services to people on holiday and using the beaches. A Committee member highlighted a recent experience in a very busy Emergency Department. It was confirmed that hotels and bed and breakfast accommodation was targeted and that there was also prevention work on sun exposure, etc.
• It was confirmed that anyone accessing 111 services who required 999 would be directly transferred or an ambulance sent, without any further delay in the system.
• The Portfolio Holder for People and Homes referred to a recent positive experience at an urgent treatment centre and the need to embed 111.

• RESOLVED that the update on the Integrated Urgent Services including the NHS 111 and NHS 111 First Programme be noted.