NHS Ayrshire and Arran - redesign of urgent care - pathway finder programme: rapid external review

Process and methodology

This rapid review process incorporates both quantitative/numerical data (including changes in service presentations (demand); service response (workforce resilience and buy-in); communications/messaging to both the public and to colleagues who provide care to the public; public expectations and responses to service change. The assessment considers the early NHS A&A pathfinder findings, alongside the experience of NHS 24 and SAS. The state of readiness of all territorial Boards across Scotland is also under continuous review by SG.

The review considers how to assimilate RUC development and delivery throughout Scotland, informed by evolving findings from NHS A&A. It will also be important to incorporate learning from comparable models elsewhere both within the UK and beyond. The limitations of this present review process need to be stated clearly from the outset. A SG purview of early progress in NHS A&A and the readiness for further roll-out across Scotland is also being informed by all territorial Boards, NHS 24 and SAS internal individual readiness assessments.

The terms of reference of the Review are included as Annex 1; the Review engagement process is listed in Annex 2; the adjunct data analysis which informed the Review can be found in the supporting files section of the web page; a specific focus on urgent mental health care is discussed in Annex 3; and a rapid literature review of evaluation of models of urgent care, undertaken by Healthcare Improvement Scotland (HIS) can be found in the supporting files section of the webpage.

Guiding Principles

In conducting this review eight guiding principles below have been considered, borrowing from the National Review of Primary Care Out of Hours Services: Pulling Together: Transforming Urgent Care for the People of Scotland, published in November 2015.^[1]

Urgent care services should be:

• Person centred - both for those who receive care and also for those who deliver care
• Intelligence led - making the most of what we know about the population and their needs.
• Assets optimised - making best use of all available resources, workforce and infrastructure
• Outcomes focussed - ensuring best decisions for both the care of population and those who deliver it

In addition, these services should be:

• Desirable - high quality, safe and effective
• Sustainable - resilient on a continuous basis
• Equitable - fair and accessible to all, according to need
• Affordable - making best use of public funds and securing value for money