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Demand and capacity across the Urgent and Emergency Care pathway in Greater Manchester

Sunday 14th June 2020

During 2019/20 NECS was commissioned to review the demand and capacity across the Urgent and Emergency Care pathway in Greater Manchester.  NECS developed a bespoke system balance model for 11 localities based on the Six Steps to Managing Demand in Social Care. Having a system balance model that links both social care and health data has allowed for more informed and joined-up working.

In 19/20 the Greater Manchester Health and Social Care Partnership (GMHSP) commissioned NECS to review the demand and capacity across the UEC pathway due to the challenges experienced during the last two quarters of 2018/19 with performance against the four hour A&E standard below 85%. The partnership is made up of ten localities which consist of ten CCGs and eleven local authorities which account for a population of two million people. NECS developed a bespoke system balance model for the 11 localities within GMHSP based on the John Bolton’s academic model: Six Steps to Managing Demand in Social Care. Specifically NECS were asked to focus on step 2 looking at the response from the acute hospital, how this is managed and what are the outcomes for older people. NECS included in the model, social care data that was available at the time, to enhance and supplement the model’s capability and insight. Using three years’ worth of data covering health and social care the NECS approach allowed for the opportunity to undertake trend work and all the data was used to support the recommendations of the NECS clinical review team. Each locality received final reports which included the key priority areas aimed at improving UEC performance. Following the closure of the project we have seen some of the NECS recommendations being implemented in GMHSP. In one locality primary care capacity as been prioritised for winter and in another we have seen them further evolve the model by using community data to track ED discharged patients. Having a system balance model that links both social care and health data has allowed for more informed and joined-up system level conversations with colleagues feeling a sense of ownership because the model puts the emphasis on the balance of the entire system not just one side of it.