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Urgent and emergency care programme

 

Managing demand for urgent and emergency care remains to be a significant challenge, placing increasing pressure on staff across primary and community care services, the ambulance service, emergency departments, hospitals and other essential health and social care services.

 

HEIW is actively engaged in various initiatives to improve the quality of care and patient experience, and to strengthen the resilience of urgent and emergency care services.  These efforts are supported by targeted workforce actions aligned with the Six Goals for Urgent and Emergency Care Policy Handbook, ensuring that individuals receive the right care, in the right place, at the right time.

 

The National Six Goals workstreams focus on:

 

 

 

 

 

For further information about our urgent and emergency care work, please contact HEIW.UEC@wales.nhs.uk

 

  • Health and Wellbeing Framework for People Living in Care Homes in Wales

 

We are supporting the Welsh Government-led task and finish group to reimagine the All-Wales Care Home Framework (2020) with the aim of improving healthcare for adults living in care homes. Stakeholder briefing and engagement events are planned during early 2025.

 

A skilled and sustainable workforce will be essential to the success of this initiative.

  • Call Handling Guidance for Vulnerable Groups

Guidance has been developed to assist call handlers in effectively communicating with potentially vulnerable groups, ensuring equitable access to urgent care services. Call Handling Guidance

 

This interactive resource promotes understanding of the needs of the following potentially vulnerable groups when calling 111 and other services:

  • children and young people
  • people with learning disabilities
  • people with cancer
  • people who are sight-impaired
  • people who are hearing-impaired
  • autistic people
  • people whose first language is not English.
  • Remote Clinical Decision Making

The Covid-19 Pandemic prompted health services to adapt their operating models, with a significant shift towards remote practice. This highlighted the importance of remote clinical care and provided the impetus to review the educational requirements for this specialised way of working.

As part of the Strategic Review of Education during 2023/24, procurement of a Level 7 Remote Clinical Decision-Making standalone specialist module was agreed.  Work is progressing rapidly to develop the curricula requirements, which aims to teach clinicians how to practice their profession remotely through a work-based learning route, set to be in place by September 2026. 

  • All-Wales Mental Health ‘111 press 2’ Practitioner Competency Framework

Aligned to the Strategic Workforce Plans for both Mental Health and Primary Care, we are developing a competency and career framework for Mental Health Practitioners working in 111 ‘press 2’.  The majority of this workforce are non-registrants, and the framework aims to provide a clear career path to improve retention.   

 

The Framework will be designed to strengthen Urgent Primary Care (UPC) services by supporting the learning and development of the mental health workforce.

  • Verification of Expected Death in Community Settings

Recognising the benefits of a holistic approach to the verification of expected death (VoED), an  online training package has been developed to improve the competence and confidence of healthcare professionals in community settings, including care homes, in performing VoED duties and ensuring consistent service provision.

A ‘Verification of Expected Death Network’ is available via Y Ty Dysgu, to provide ongoing support to healthcare professionals post-training.

 

  • All-Wales Urgent Primary Care Practitioner Competency Framework

The All-Wales Urgent Care Practitioner Competency Framework has been developed with a focus multi-disciplinary working. It aims to support learning, enhance clinical skills, and ensure consistent competencies across multi-disciplinary teams, specifically within urgent primary care and out of hours settings.

The framework is designed to strengthen Urgent Primary Care (UPC) services and enhance workforce sustainability, particularly among the senior clinical workforce, by supporting the learning and development of the multi-disciplinary team.  The framework is currently being piloted within CVUHB and HDUHB.  Its impact will be evaluated during 2025 before planned widespread implementation. The evaluation report is expected in December 2025.

An ‘Urgent Primary Care Practitioner Network’ is available via Y Ty Dysgu, where a range of education and training resources are currently being developed to complement the framework.

  • Optimising Hospital Patient Flow

To support the implementation of the Hospital Optimal Patient Flow Framework, which integrates key approaches to support healthcare professionals to improve patient flow and deliver timely pathways of care, a series of animations have been developed.  Additionally, two new roles have been created:

  1. A ward-based activity coordinator, and
  2. A ward-based patient flow coordinator

An ‘Optimising Patient Flow Network’ will soon be launched via Y Ty Dysgu.  This network will host a range of education and training resources to help professionals improve patient flow, reduce hospital deconditioning, and deliver timely care pathways.

 

  • Preventing Deconditioning

Deconditioning, which can lead to functional losses in areas such as mobility, continence, and cognitive function, is a significant concern for patients, especially those with prolonged hospital stays.

In collaboration with the Goal 5 team, we have created a film to raise awareness of the impact deconditioning can have on patients and their families.  This films also aims to educate our NHS workforce to recognise the signs of deconditioning so they can take measures to prevent it from happening in health and care settings.

 

  • Discharge to Recover then Assess (D2RA)

Discharge to Recover then Assess (D2RA) training resources have been developed to reinforce the embedding of the D2RA pathways across NHS Wales. As part of the National Six Goals Optimal Hospital Patient Flow Framework, these resources aim to help healthcare professionals improve patient flow and deliver timely care pathways.

The resources are designed for multi-professional teams across the entire healthcare system (primary, community, and secondary care) and focus on practical, on-the-ground implementation.

You can find the resources, ‘An Introduction to the D2RA model’ and ‘Implementing the D2RA model in Wales’, by entering ‘D2RA’ in the course search facility on ESR.  For students and those employed outside of NHS Wales, the resources can be accessed via the learning@wales platform.

 

  • Trusted Assessor Toolkit

The Once for Wales Guidance for Trusted Assessor Roles, released in December 2022, aims to address issues causing delays at key points in the care and support pathway. To support this guidance, the online toolkit offers supplementary guidance and information to support regions further develop Trusted Assessor roles and functions.