BLMK ICB Integrated Urgent Care (111 & Out of Hours) Service

Integrated Urgent Care (NHS111, Clinical Assessment Service, GP OoH's) services. Integrated Urgent Care Services are inextricably linked to delegated primary care commissioned services and have been considered together when determining a sustainable approach for provision within BLMK. The transformation of IUC directly impacts core general practice and primary services, specifically same day and urgent general practice and vice versa. National policy developments including the development of unscheduled care coordination hubs has been an important consideration as the services are delivered against a national NHSE Service Specification as follows:

NHS111 is a remote triage service accessed via telephone or online. Both services use a Clinical Decision Support System called NHS Pathways, to support the remote assessment of callers to 111 or 999, or visitors to NHS111 Online. The 111-telephony service uses an Interactive Voice Response (IVR) system. This provides an initial filter to direct callers along the appropriate pathway within the NHS111 process. It can also connect callers directly with another service such as a Mental Health Crisis Team.

The CAS contains an MDT, with at least one senior responsible GP available 24/7 with additional GPs rostered according to demand. Working with them, also rostered according to demand and local need are specialists such as advanced nurse practitioners, pharmacists, dental nurses, mental health nurses and palliative care nurses. During consultations, CAS clinicians will use a Clinical Decision Support System (CDSS) or an agreed clinical protocol to complete the episode on the telephone where possible.

The GP OoH's service manages all Primary Care Dispositions that have resulted from the NHS111 process during the GP Practice out of hours periods (18:30 to 08:00 weekdays and all day at weekends and Bank Holidays). This is for both NHS111 telephony and NHS111 Online outcomes. The service is delivered both remotely and face to face. Remote assessment will be by telephone and video if available (GP Triage). Face to face services will be delivered from bases known as IUC Treatment Centres (Base Visit) and in patients' homes (Home Visit). GP OoH's services will use a Clinical System to record all episodes of care and will have access to Patient GP Records.

The ICB are intending to award a contract an existing provider following direct award process C and the approximate lifetime value of the contract is £40.6m plus activity growth, cost inflation and efficiencies. The services are intended to be provided for a period of three years from 01st October 2025 to 30th September 2028.