Goal 3: Clinically safe alternatives to admission to hospital
People with Urgent or Emergency Care needs can access appropriate and safe care close to home, and with as much continuity of care, as possible. Admission for ongoing care to an acute hospital bed should only occur if clinically necessary.
Linked to Goal 1 and Goal 2, and the establishment of an integrated 24/7 urgent care service, Health Board and partners will work together to achieve this goal.
Quality Statement:
- People with Urgent or Emergency Care needs can access appropriate and safe care close to home, and with as much continuity of care, as possible. Admission for ongoing care to an acute hospital bed should only occur if clinically necessary. Community based nurses, allied health professionals and GPs should have timely access to GP and / or specialty advice and guidance to support safe decisions about a person’s Urgent or Emergency Care needs. This includes helping them to remain at home; receive timely follow-up care after accessing the ambulance service or accessing the right hospital setting, first time.
- People who are assessed for bed-based intermediate ‘step-up’ care are given clear advice about the support the service will be able to provide and, if accepted for intermediate care, start the service within two hours of referral in line with NICE guidance.
- People who have a clinical need for a hospital-based urgent or emergency face-to-face assessment, diagnostics and/or treatment are always considered for management on an (ambulatory) same day emergency care pathway.
- Older/frail people, and people nearing the end of their lives, will be assessed quickly at the front door or adjacent to the Emergency Department with decisions on their care acted upon by a multi-agency team. This should include a system that is able to respond to peoples’ specific needs to prevent unwanted or unnecessary admission to hospital, focus on maintaining nutrition and hydration, mobility, communication and control.
- Individuals will have available, outside of normal working hours, crisis cafés or sanctuaries in their local communities which will provide compassionate safe support for those in mental health crisis.
To read more about Goal 3 including initial priorities, how health and social care systems will be supported to achieve this goal and how success will be measured, please refer to the Six Goals for Urgent and Emergency Care Policy Handbook.
Goal 3 Leads:
Strategic Programme for Primary Care: Sue Morgan, National Director and Strategic Programme Lead for Primary and Community Care - sppc@wales.nhs.uk
Same Day Emergency Care: Rachel Taylor, Assistant Director of Transformation for NHS Executive - sbu.duTransformation@wales.nhs.uk
