Collaboration in urgent and emergency care

Dr Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care, discusses our recent report highlighting positive examples of provider collaboration in urgent and emergency care during the coronavirus pandemic

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The COVID-19 pandemic has brought the importance of partnership working in health and social care into sharp focus. System working and the integration of health and social care has been high on the agenda for some time, and we’ve already seen the benefits it brings for the local population, individual people, and providers. But we also know that different areas are at different stages of progress towards integration. The pandemic has served as a catalyst for change in many areas, with providers rapidly changing and developing services to make sure people can get the care they need quickly and safely. However, it has also exposed the inequalities that exist in our society, including those in health and care.

We know that despite the challenges there has been some excellent and innovative work, as well as common challenges and barriers, that all systems can learn from. Our programme of provider collaboration reviews (PCRs) aims to share some of this learning between systems and providers to support their ongoing planning and response to the pandemic and as we move ever closer towards recovery.

In autumn 2020, we looked at how providers were working together in urgent and emergency care (UEC). We spoke to a range of providers, including primary care, adult social care, ambulance services and NHS 111. Winter combined with the pandemic means that UEC services are under exceptional pressure, and so it is important to acknowledge that our reviews took place under different circumstances to those currently being experienced.

We found some fantastic examples of creativity and innovation and of rapid developments where providers worked well together in responding to the pandemic. We felt it was important to share these examples now, to help systems optimise their responses to the ongoing challenges and beyond. We saw how providers have joined forces to ensure UEC services and pathways were adapted quickly and safely, and that people received the right care, in the right place, at the right time.

This is the first PCR that looks at local systems and inequalities. Although systems did not consistently focus on inequalities and specific population needs, we saw many examples of initiatives to consider people’s individual needs, focused on Black and minority ethnic people. For example, some providers worked with communities to address inequality, seeking views of specific population groups to improve their awareness of health inequalities and consider how to tackle them.

There are major challenges in UEC, and improvements are needed if we are to manage future pressures on the system better. We hope by sharing positive examples and lessons now, providers and systems can build on what has worked well for others as they continue to respond to the pandemic. The PCRs are an important opportunity to support local, regional and national improvement. Providers may also want to take a look at Patient FIRST — a support tool designed by clinicians, for clinicians. It includes practical solutions that all emergency departments could consider, as well as guidance for senior leaders at NHS trust and system level.

Our full report is expected to publish in spring, and will present a wider picture of our findings, including innovative ways of working and where providers have faced challenges or barriers to working together as partners. In the meantime, I would encourage you to take a look at the examples published in our report.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

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