The challenge
To design a System Coordination Centre service that meets the requirements of both NHS England (NHSE) and the individual Integrated Care Boards (ICBs).
NHSE service specifications require ICBs to provide 8am-6pm service seven days a week, 365 days a year. ICBs can however choose to provide the service 8am-8pm. Evidence shows that early evening is consistently pressured for providers and ambulance trusts.
Our response
NECS worked closely with both NHSE and the North East and Yorkshire (NEY) ICBs to design and deliver SCC services following inception in December 2022.
NECS provides a tailor-made service to three of the North East and Yorkshire ICBs. Humber North Yorkshire (HNY) ICB commissions an 8-8 service, West Yorkshire (WY) commissions weekends and bank holidays 8-6 only, whilst South Yorkshire (SY) commissions a weekday 5-8, plus weekends and bank holidays 8-8. Recent service transfers saw NENC fully managed SCC, devolve to ICB control.
NECS offers flexibility to the ICBs commissioning the service. We can tailor a team to work ‘in’ and ‘out of hours’ for a seamless service, or ‘out of hours’ only, complimenting the ICBs weekday provision. SCC is an evolving service with regular variations to reporting requirements. The NECS management team ensures staff engagement, training and continuous improvement through learning, benefits realisation and lessons learned exercises.
For ‘out of hours’ services, NECS uses a dedicated team, carefully selected from our wider workforce, who provide regular out of hours support on an overtime basis. Variations in the current contracts reflect the differing requirements of each ICBs. In times of extreme pressure, our way of working provides resilience and opportunity to flex the service with additional staff, extended hours or both.
For ‘in hours’ provision, NECS works closely with ICBs to assess their service requirements. Professional staff at varying levels provide a dedicated service, fitting with the requirements of the commissioning ICB.
NECS’ customer Humber North Yorkshire uses a multi-skilled team including senior management, clinical skills and administration. The SCC team coordinates, and facilitates, where necessary, decision making, responding to system pressures with multi-agency input from ambulance, acute and mental health trusts, local authority, community care providers and NHS 111, whilst keeping NHSE informed of any escalations and issues by exception.
Currently five ICBs nationally, three in NEY, use the RAIDR Smart System Coordination Centre. NECS developed RAIDR with data reporting aligned to the NHSE OPEL core parameters. The system provides real time data for the management of operational pressures across each system. Data including ED demand, ambulance pressures, bed availability, patient flow, discharges etc. gives improved transparency across all levels of the NHS. Excellent quality data also supports oversight of patient safety and patient centred decision making across the urgent and emergency care pathway through clear and consistent identification of risk to access to care for patients.
Outcomes
- NECS SCC supports improved waiting times in ED, reduced ambulance handover delays and enhanced system working across partners. All have a direct impact on the patient journey and can lead to improvements in patient care, Emergency Preparedness and Response to major incidents, including industrial action.
- SCC supports mutual aid arrangements and patient repatriations between neighbouring regions and Trusts.
- Supporting, developing and following escalation protocols. Engaging higher levels of authority to ensure critical decisions are made promptly and collaboratively.
- Emergency Preparedness and Response to major incidents, including industrial action.
“I just wanted, in my capacity as the ICBs Acting Deputy Chief Executive and Chief Operating Officer and Accountable Officer for EPRR and SCC, to offer my sincere thanks and appreciation to you all in supporting the unprecedented system pressures that we have been experiencing in recent weeks, especially earlier this week.
“The work you have been doing, often going well beyond the call of duty and extended hours, has been truly appreciated and recognised and invaluable in helping to respond to the pressures and keeping people safe across Humber and North Yorkshire.
“Your flexibility in supporting on call colleagues late into the evening, and proactively spotting patient safety issues, and escalating accordingly, are just a couple of many examples. I know that both my Planning and Performance team, and the NHSE regional team, have been very positive in the recognition of your work so I just wanted to add to that.
“Thank you very much to you all – and please extend this thanks to others in the out of hours team as well.”