Integrated Urgent Care and non-urgent care services

The Health Care Services (Provider Selection Regime) Regulations 2023, Paragraph 10 - The Most Suitable Provider Process is being used to commission this service. This notice will be live for fourteen (14) days from the date of publication.

This is a notice to inform the market of the intention to award a contract for Integrated Urgent Care and non-urgent care services.

The provider will need a secure and sustainable clinical workforce (GPs and other appropriate trained mixture of nursing and Allied Health Professional staff), with the relevant network of support workers such (e.g. Healthcare Assistants and Drivers/Call handlers) to be able to provide a range of urgent primary care services across Nottinghamshire.

The provider must be able to deliver the services across the City and County with access to estate as required at strategic locations within the Nottingham and Nottinghamshire area.

The provider must also have the pre-requisite digital capacity to operate virtually as appropriate including connectivity to primary care, community and acute clinical systems.

The provider must be able to flexibly deploy resource across the following portfolio of services, managing predicted demand profiles and with the operational capability to flex up and down within mutually agreed thresholds. This will offer resilience and sustainability across a set of key urgent care services including;

1. Care Co-ordination and non-clinical call handling
2. Clinical Assessment and Care Navigation
3. Support to Primary Care - including delivery of General

Practice Out-of-Hours

4. Urgent Treatment Centres and Primary care in Emergency

Departments

5. Outbreak Management including Covid Medicines Delivery

Unit, flu, measles and MPox vaccinations

Care Coordination and non-clinical call handling

The provider must have proven operational call handling services to run the systemwide on-call command arrangements as part of Emergency Preparedness, Resilience and Response, provided via the "On-call Gateway".

The provider must take responsibility for receiving calls from clinicians that have treated a patient at home out-of-hours and conveying messages back to the patient's GP practice.

The care coordination hub should also be available for other providers in the system to use as a single point of access for all forms of communication that need to be dealt with outside of the normal GP practice opening hours.

Clinical Assessment and Navigation

The provider will be responsible for operating an Urgent Care Co-ordination Hub (UCCH), operating as a 'single point of access', delivering clinical assessment and navigation. The service will be delivered by an integrated workforce that must work together seamlessly and interdependently, achieving the required outcomes for the population of Nottingham and Nottinghamshire.

The Urgent Care Co-ordination Hub will:

• Operate 24/7
• Receive referrals from NHS 111(online and telephony), 999 and health and care professionals including GPs, paramedics on scene, care homes, community services and acute services.

Specific pathways for the clinical assessment service that will be delivered as a minimum requirement include:

o A rapid remote clinical assessment of 111 and 999 calls designated to attend Emergency Departments ("ED validation"), ensuring that patients can be signposted to more appropriate care settings (e.g., Pharmacists) or treated remotely by locally based clinicians. The service will operate a response time of 20 mins for 1 hour ED dispositions and 1 hour for 4 hour ED dispositions and take a minimum of 3,100 calls per annum. This service will also be able to book the patient into an appropriate face-to-face consultation, including routine general practice and urgent treatment centres. 75% of these calls should be managed without onward referral to ED.

o A rapid remote clinical assessment of calls deemed to be Category 3 & 5. This service should also include the ability to provide a response team that can arrive at a patient's home and undertake a clinical on-site assessment and help the patient to get up, if appropriate, and avoid an ambulance visit or hospital admission. These calls will receive a response time of 30 minutes with 20% of calls managed with self-care, 63% managed without ambulance response or referral to ED and a minimum of 22% referred back to the ambulance provider.

o A rapid telephone direct access clinical consultation service for ambulance clinicians to access; providing alternative routes for treatment other than the ambulance crew attending an Emergency Department with the patient. 96% of these should be managed without referral to ambulance or ED.

o A rapid telephone direct access clinical consultation service that can advise and support residential care and nursing homes to access specialist support, urgent care visits, frailty pathways and alternatives to ambulance conveyance and ED attends. These calls will receive a response time of 30 minutes.

• Operate as a 'trusted assessor' model for patients requiring navigation and onward referral to the right place, first time, removing the need for the receiving service to 're-assess' the patient.

The service will require direct access to;

o Urgent Community Response Services

o Acute services including ED consultant advice and guidance, frailty, medical and surgical pathway

o Acute based services offering alternative to admission such as DVT pathways

o Primary care services in and out of hours via appointment booking and PCN services

o Urgent Treatment Centres via appointment booking

o Community Services including virtual wards

o Escalation processes for patients assessed as requiring an emergency response including ambulance response and Emergency Department

• A call centre service that can deal with up to 160,000 urgent Primary Care clinical triage calls during the periods that the GP practices are closed. The remote and face-to-face elements will need to be managed a…