What is the challenge your project is going to address and how does it connect to the theme of 'How can we improve across system boundaries?​

Currently there is a gap in the service for residents and visitors to the historic coastal town of Rye in East Sussex, with the ambulance service facing challenges reaching people requiring emergency care, particularly in busy holiday periods.  Since 2018 a seasonal demand unit, run by SECAmb, based at Camber beach, near Rye, has operated between April and September.  Recent analysis of the way the service is used has shown an increasing demand for urgent care, which extends beyond traditional holiday periods.

The Charity and SECAmb intend to work with organisations and local residents to co-design an urgent response service for patients with minor injuries and illness unit based at Rye Hospital.  There is support for this to be run and managed by SECAmb, with the unit being staffed by paramedics.  Community First Responders (CFRs) could be based at the unit, thereby creating an opportunity for shared learning and training.

What does your project aim to achieve?

The proposed service would improve the quality of patient experience and outcomes by providing:

·       Immediate access to assessment, triage and where appropriate, treatment          of minor injuries and illnesses by skilled clinical practitioners;

·       Ongoing support through the range of health and social care facilities at                 Rye Memorial Care Centre, as detailed above.

An MIIU service at Rye Memorial Care Centre would:

·       Reduce demand on A&E departments at hospitals in Hastings, Ashford                  and elsewhere in Kent and East Sussex, potentially contributing to                            reducing  waiting times for those using these services.

·       Make best use of the finite resources of the ambulance service, helping to           increase productivity and reduce waste through easier access,

·       Free up the workforce to attend to calls that are classified as life                                threatening, critical and/or likely to require urgent treatment at a                                 secondary  care facility.

How will the project be delivered?

The project will be delivered by:

·       Running workshops to co-design the service with agencies and users;

·       Facilitating effective Patient Public Involvement (PPI);

·       Conducting an evidence review, scenario modelling and consultation to                explore potential models, systems and processes;

·       Time for developing associated care pathways to ensure effective                              signposting and on-going support;

·       Exploring the potential for collaborating with SECAmb to widen the remit            of the MIIU to include a frailty service, such as the one currently operating            at SECAmb Make Ready Centre in Ashford, Kent;

·       Development of a communications strategy to promote the new service;

·       Evaluation of the service, working from a jointly developed Theory of                      Change, continually testing and refining the model using the PDSA cycle.

We would adopt a flexible approach, enabling the model to evolve and develop.  We are not aware of this ambulance service led model in a Community Hospital operating anywhere else in the UK.

How is your project going to share learning?

We would explore similar urgent care services and share learning through Q and Community Hospital Association networks.

We would hope to embed this new service through negotiated care pathways and shared learning across all agencies.

We would evaluate this novel service with all concerned, including patients and agencies and share findings within the CHA, Q Exchange team, SIGs, speaking at conferences and publishing the process and outcomes in journals.

We plan to develop a communications strategy to ensure our learning, the new service model and approach taken to quality improvement and evaluation is shared widely.

We believe this approach to urgent care for minor injuries and illnesses would be a realistic and practical solution for other community hospitals and Primary Care providers willing and able to work collaboratively, with their local ambulance service to manage the demand on its emergency services.