Prime Ministers Challenge Fund Application by Coventry and

Prime Minister’s Challenge Fund Application by Coventry and Rugby GPs January 2015

Three schemes: Scheme 1: Extended hours hub • Central Coventry City hub • Routine appointments (improving screening) • Appointment only (4 -8 weekdays / weekend mornings) • Urgent appointments (reducing A&E pressure) • Face to face, telephone, email and • Shared records video conference offered NHS 111 GP practices Walk in Patients A&E Urgent GP stream Routine stream Weekend or 8 -10 booking 4 -8 pm booking Extended hours hub (Single point) Shared Patient record PMCF Schemes Face to face Existing services Patient flow Tel No further service GP practices (e. g. For referral)

Three schemes: Scheme 2: Primary Care led frailty team • Edmonton Frailty • Home assessments (keep people safe) • Multi-skilled team (incl. Social and voluntary care) • Care co-ordinator / navigator to establish services against care plan • Hospital assessments (speed up discharge) Shared Patient record Care navigator Discharge Care plan Prevent and educate Gerontology Frailty Scale Acute frailty unit Primary care frailty team 24 -48 hr health and social and carer assessment Acute nursing team Integrated Neighbour hood teams Patients Frailty stream Acute frailty pathway A&E Existing services under GP PMCF Schemes Existing services Patient flow

Three schemes: Scheme 3: GP in A&E • Formal defined protocols, training • Expedited assessment and referral and systematic approach / discharge • GP Led with ANP support (1: 2 ratio) • Links to other two schemes • c. 1 in 5 people seen (c. 38, 500/yr) Patients Active case finding by GPs A&E Stream (80% plus or 400 per day) e. g. ED majors Streaming by A&E nurses GP stream up to c. 20% (100/day) Patient data analysis Shared Patient record GP in A&E GP consultation in A&E Education (Attendance reduction) Direct appointments / referral bookings GP practice / Scheme 1 PMCF Schemes Scheme 2 Frailty Existing services Home Patient flow Other community Acute referral

Key benefits / outcomes Strong focus on reducing pressure in urgent care pathways Scheme Benefits / outputs 1: Extended Hours • • • Additional c. 25, 000 appointments (TBA) Reduction in A&E attendance Improved patient experience 2: Frailty • • • c. 2, 500 cases with enhanced review and care co-ordination Faster return to home Reduced DTo. C Reduced return to treatment Reduced A&E attendance • • • c. 38, 500 additional ‘appointments’ Improved 4 hr wait Improved patient experience Reduced attendance Reduced admissions 3: GP in A&E

Implementation An agile, phased approach to implementation Q 4 ‘ 14/’ 15 Federation preparation FY ‘ 15/’ 16 Design, Project management and evaluations PMCF Funding starts PMCF Funding ends Scheme 1: Extended Design hours Scheme 2: Frailty team Phase in Design Phase in Service starts Full operation Full design realised Service starts Scheme 3: GP in A&E FY ‘ 16/’ 17 Extended running Decision to extend Extended running Full operation Full design realised Decision to extend Full operation Full design realised Commission Stop / Go Extended running Commission Stop / Go

Funding: Current view of PMCF request (excluding additional funding) Scheme 1: Extended Hours Scheme 2: Frailty Scheme 3: GP in A&E Governance and PMO Benefits realisation Design and Analytics TOTAL £ 000’s 813 1, 215 873 318 150 180 3, 549