Strategic Framework for
GP Out-of-Hours
Public Meeting
13th August 2012
Dr E.G.J. O’Neill
Consultant Medical Adviser
Directorate of Integrated Care
Health & Social Care Board
Public
Consultation
Closing date –
28th September
2012
Public Meetings
Outline
1. Introduction and background
2. Our plans – Strategic Framework
3. Your say
Background
1. GP Out-of-Hours – for urgent primary care
conditions when GP practices are closed
2. 5 provider organisations
3. Last year over 574,000 calls
Call Volumes
When
you
contact
us…..
Triage



Immediately life-threatening:
these calls should be passed to 999
ambulance within 3 minutes.
Urgent:
appointment given at initial contact or
triage within 20 minutes by a health
professional
Less urgent:
triage within 1 hour by a health
professional
Face-to-face consultation

The health professional will determine if a
person needs a face-to-face consultation
and the appropriate timescales.

A face-to-face consultation, if required,
usually takes place at an Out-of-Hours
centre or occasionally at a patient’s home or
place of residence.
Face-to-face consultation



Urgent:
within 1 hour if required after completion
of triage.
Less urgent:
within 2 hours if required after
completion of triage.
Routine:
within 6 hours if clinically appropriate
after completion of triage.
How do we do?
How do we do?
Complaints
 In
2011/12 – 99 complaints
 574,811
contacts
 Complaint
rate is approx 0.017%
Strategic Framework
1. Simplify access to GP Out-of-Hours e.g.
single telephone number
2. Improve operational efficiency
3. Improve alignment with other healthcare
services
Simplify access to
GP Out-of-Hours
Simplify access to
GP Out-of-Hours
Simplify access to
GP Out-of-Hours

reducing current telephone numbers
from 7 to 1 access number

consolidating the Out-of-Hours six
computer systems to one regional
system

sharing call handling workload
among call centres at busier times
Simplify access to
GP Out-of-Hours

implementing more sophisticated
telephony to manage this sharing of call
handling workload

improving communication with the
public in terms of appropriate use of the
service and how to access the service
Operational efficiency

continuing to develop standard protocols
and processes

standardising clinical governance:
including best practice pathways for
common presentations and performance
management systems

standardising the triage process, through
decision support tools, agreed performance
management processes, and refinement of
triage processes
Operational efficiency




sharing triage workload across the
region at busier times (calls and
consultations)
consolidate the number of triage centres
at times of low demand e.g. overnight
using technology to co-ordinate and
facilitate home visits: progress towards
mobile working at quieter times, where GPs
travel to see patients, and Out-of-Hours
centres are only opened as required for
clinical consultations
ensuring the service is developed in a way
that best meets patients’ needs
Alignment with services

aligning call handling and triage processes
with Northern Ireland Ambulance Service

enhance collaborative working and agree
protocols

to facilitate the easier transfer of appropriate
calls to the ambulance service

transfer of appropriate “Category C”
ambulance calls to the GP Out-of-Hours
service
Alignment with services

retaining provision by local
organisations of home visits to see
patients, and the facility to see GPs in
local Out-of-Hours centres

allows for future development, to
complement and align with the development
of A&E (ED) and unscheduled care services

retains flexibility to enable clinical provision
which is responsive to local need (through
Local Commissioning Groups) and to
primary care providers
Alignment with services

considering the expansion of service
provision (review interface with other
services)

staff and infrastructure could be used, for
example, to provide a call handling service
for other services such as social services
contacts during the Out-of-Hours period

Co-location and integration of other services
would simplify and improve patient access
Expected benefits
Service
More efficient and better quality service
Better management of peaks and troughs
Formal common standards
Better governance
Performance management
Financial efficiency
Development of the operating model
Optimised use of workforce and centres
Patient
Clear patient pathway (single phone number)
Removal of geographic boundaries
Patient focused information
Consistent processes
Faster response at peak times
Choice of centre to attend
More coordinated joined up service
Your Say
Respond to the consultation
Closing date – 28th September 2012
Dr Sloan Harper (GP Out-of-Hours Consultation)
Health and Social Care Board
12-22 Linenhall Street
Belfast, BT2 8BS
E-mail: OOH.consultation@hscni.net
Website: www.hscboard.hscni.net