Changes to Urgent & Emergency Care in Oldham

National transformational plans to improve the way people receive urgent care, advice and treatment in Greater Manchester are being implemented from this month and across Oldham we have begun the three stage rollout of the changes for all our patients.

This has begun with adopting a new way of working that encompasses a pre-assessment and screening service, for patients who come direct to the Emergency Department (A&E) at the Royal Oldham Hospital where they have now begun to experience a slightly different way of being treated.

The impact of social distancing also means we need to ensure that numbers in our Emergency Departments are reduced wherever possible.

Stage one

On arrival, patients are assessed by an Advanced Care Practitioner and then go through one of the following streaming processes:

  • Transferred to another department in the hospital or community
  • Where clinically required referred into the Emergency Department
  • Given an appointment time to come back to a hospital department. This may be the same day or on an urgent basis depending upon clinical need
  • Given an appointment with a GP or primary care clincian, where possible at their own GP practice
  • Advised to contact their own GP or go to a pharmacy, if this is more appropriate
  • Provided with self-care advice

This coupled with our stringent Infection Prevention and Control strategy will help keep our patients and staff safe, see those patients who need to be seen as quickly and safely as possible, and reduce the risk of infection for everyone. 

Our clinicians have worked together with commissioning, primary and secondary care colleagues across Greater Manchester to develop this model of care that will help us to improve our local patient experience of urgent and emergency services safely. They will all have a shared and consistent set of principles and processes that will help to connect the patient to the right place and level of care.

This approach was phased in from Monday 26 October. To begin with, the service at the Royal Oldham Hospital is in operation on Mondays, Tuesdays & Fridays, 8am-8pm and will expand over time to operate 7 days a week.

We have gone through rigorous testing of this new way of working and have worked with our patients to gain their experience and feedback to ensure the test of change works.  Ongoing we will be monitoring patient experience to ensure we are meeting their needs.

To support this, the Walk-in-Centre at the Integrated Care Centre has been adapted into a Hub to meet Covid regulations/standards and is providing additional support by ensuring patients have access to a range of services that are delivered by a multidisciplinary team.

The Hub will support Primary Care, the Emergency Department and Care Homes by seeing patients who have presented with needs that can be met by providing telephone/video consultations and face-to-face consultations, where appropriate.

Stage 2

In advance of the national rollout, we will be introducing NHS 111 First (part of NHS 111) meaning non-emergency patients will be asked to call 111 instead of going straight to the Emergency Department.  Initially this is for our systems to link together and to answer any patients that call 111 currently.  When NHS 111 First comes into fruition (see stage 3), it will offer patients access to urgent and emergency services in new way.

A patient will contact NHS 111 First whether online or by phone, if they have an urgent, but not serious or life-threatening medical need, as an alternative to self-presenting as a walk-in to the Emergency Department (A&E).

If the patient does not need to attend the Emergency Department straight away, local clinical assessment services will call them back to complete a more in-depth assessment of the patient. This service is staffed by doctors and other health professionals and has knowledge of and access to a wide range of local services to support the patient’s needs. The service will be able to offer self-care advice or book the patient into appointments into a community service. In some cases, an appointment might be booked to attend the Emergency Department.

This will further assist in helping to ensure fewer patients in our waiting rooms and that wait times are reduced.

The system will be given a soft launch, with only minor communications activity planned in to begin with, in order for our local services to be tested and refined.

Stage 3

In December, we will see a national public campaign that will be launched advertising the NHS 111 First service; giving the public all the information that they need to access our urgent and emergency care services and we will then expect patients to ring NHS 111 First before accessing services.

Staff are currently being recruited by the North West Ambulance Service to handle the anticipated increase in calls.

The benefits

Here’s a summary of some of the benefits that can be gained from these changes:

  • People who do need rapid emergency care in Oldham will be seen and treated more quickly in a less crowded Emergency Department
  • There will be a lower risk of contracting infections, including COVID-19. By accessing remote assessment patients can be referred to their local Emergency Department only when they absolutely need to, who will be ready to receive them at a specific time
  • If the clinical assessment service refers a caller to the Emergency Department or another service they will be given a time for an appointment – so the caller can wait at home, and this shortens the time they have to wait at the hospital or other setting
  • People will be able to receive more treatment in their own homes or closer to home
  • Patients may be linked to the right specialists for their condition much more quickly
  • Reduced travel across the local area for staff and patients

Further information will be shared over the next coming months as we start to make progress with this new way of working.