Providing robust NHS Directory of Services (DoS) support is vital to facilitate signposting to COVID related care pathways at the same time as enabling flexing of capacity and clinical profiling of established urgent care services.
The challenge
NHS England sought to quickly establish a national COVID-Clinical Assessment Service (CCAS) to help support the demand for COVID-related advice and to ensure 111 did not fall over during this time. This CCAS required specific Pathways codes to facilitate patients into the CCAS and other local services, these new codes needed to be applied to the relevant services within our customer footprint safely and quickly to avoid inappropriate conveyance to A&E departments. Also, as demand patterns changed dramatically due to both the outbreak and social lockdown many existing non-COVID services had to change to ensure the wider health economy was not unduly impacted.
The approach
- A daily report of all COVID-related cases received via 111 or the CCAS shared with all commissioners and key service leads.
- Created several COVID Clinical Assessment Service profiles as well as implementing a Children's specific service in Hampshire.
- Region-wide review and updating of GP endpoints to support Direct Booking functionality.
- Use of DoS to suspend some services, add new services (Priority Assessment PODS and Hot Hubs) or expanding the clinical capability of others.
- DoS improvements for 111 on-line, in particular, Mental Health Assessment in Hampshire.
- Timely application of all NHS Pathways updates and NHS Digital DoS developments.
- Relevant updates to the ‘SCAS Connect’ directory used by SCAS Ambulance crews.
- We also had an advisory role to the NHSE Improvement Team’s work to ensure Primary Care services were using DoS to report daily RAG capacity status.
- The process is achieved through:
- 24/7 SCW DoS team in place.
- Good relationships with CCG customers and key stakeholder services (111, GP Out of Hours)
- Close working relationship with SCAS who were hosting the CCAS service nationally.
- Close working relationships with NHS Digital team who managed the GP Connect roll-out during COVID
- Ability to quickly access data streams from NHS Pathways.
The results
Maintaining DoS-related IUC KPI performances despite wider system focus on the COVID-19 response.
Supplied Pathways data used to measure and judge when key urgent care services were suspended and or re-opened.
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