A recent study undertaken by RAND Europe evaluated the work being undertaken by the Southern Cluster Urgent and Emergency Care (UEC) Vanguards (in Barking and Dagenham, Havering and Redbridge; Cambridgeshire and Peterborough; and South Devon and Torbay) in order to answer the following research questions:

  1. What impact have they had to date?
  2. What were the processes underpinning delivery and impact, and associated enablers and challenges?
  3. What can be learnt from their experiences?

Between January and September 2015, 50 vanguards were selected to take a lead on the development of new care models – eight of which focussed on urgent and emergency care (UEC).  The UEC vanguards were established in response to ‘extreme pressures’ being faced by the urgent and emergency care system in England.  These include 110 million urgent care same-day patient contacts each year, of which 85 million are urgent GP appointments and the rest accident and emergency (A&E) and minor injury setting attendances.  As Blueprints for the NHS moving forward, vanguards have a central role in the implementation of the NHS Five Year Forward View.

Using a variety of research methods, the evaluation points to:

  • A reported increase in the use of urgent care centres and a greater awareness of alternative urgent care options within Barking and Dagenham, Havering and Redbridge UEC vanguard as a result of improved front-door triage of patients
  • A reported 19% reduction in emergency department attendance by mental health patients at Cambridgeshire and Peterborough UEC vanguard through increased use of the specific mental health option in the NHS 111 and First Response service.
  • A reduction in A&E minor injuries treatments at South Devon and Torbay UEC vanguard resulting from the clinical hub facilitating better call handling and a patient centric service.

However, the research also found areas where progress has been slow.  These include:

  • The ability to book in-hours GP appointments through NHS 111;
  • The sharing of data and problems with interoperability of IT systems between providers
  • Patient and public engagement.

The evaluation makes several recommendations for the UEC vanguards moving forward:

  • Build improved capacity and skills within the workforce
  • Coordinate local and national efforts.
  • Strengthen links with all stakeholders including the public
  • Support an end-to-end urgent care pathway
  • Improve data to support a robust business case for future developments.
  • Improve data sharing and interoperability between providers

The full report is available here: https://www.rand.org/pubs/research_reports/RR2062.html