Parallel Session 3.3 Unscheduled Care Unpacked

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  • 1. UNSCHEDULED CARE UNPACKED
  • 2. Definition of Unscheduled Care‘Unscheduled care’ is defined as NHS care which cannotreasonably be foreseen or planned in advance of contactwith the relevant healthcare professional, or is care which,unavoidably, is outwith the core working period of NHSScotland. It follows that such demand can occur at anytime and that services to meet this demand must beavailable 24 hours a day Kerr Report (2005)
  • 3. Recommended shift from Assess-Transport-Diagnose-Treat to Assess-Diagnose-Talk-Treat
  • 4. Scotland Unscheduled Care Patient Flow Chart 2008/09 Rates per 100,000 Population Patient NHS24 22,450 GP 6,7001,750 1,950 1,500 12,650 Healthcare 2,950 Professional 2,000 16,400 1,150 50 100 1,050 250 300 6,850 Emergency Out of 550 A&E Ambulance Hours 27,100 150 11,000 16,050 400 150 MIU 2,750 50 50 200 7,350 50 Treated 150 at Scene/ Admitted 1,400 Not (Emergency 450 1,050 150 Conveyed Inpatient) 3,450 2,200 1,100 10,400 PAA/ARAU/ MAU 1,350 200 3,100
  • 5. Attendances by Site Type Total Attendances at A&E Services by Site Type - Scotland (April 2011 to March 2012) 160,000 140,000 120,000Number of Attendances 100,000 80,000 60,000 40,000 20,000 0 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 ED MIU/Other Source: A&E Data Mart, ISD Scotland
  • 6. 4 Hour Wait Standard Number of Attendances at A&E Services across Scotland and Proportion of those seen within 4 hours (January 2009 to March 2012) 160,000 100 98 140,000Number of Attendances Seen within 4 hours (%) 96 120,000 94 100,000 92 80,000 90 May-09 Mar-10 Jan-12 Mar-09 Sep-09 Jun-10 Jan-09 Aug-09 Nov-09 Jan-10 Nov-10 Jan-11 Feb-11 Mar-11 Dec-11 Mar-12 May-10 May-11 Dec-09 Aug-10 Sep-10 Dec-10 Nov-11 Feb-12 Feb-09 Apr-09 Jun-09 Jul-09 Oct-09 Apr-10 Jul-10 Oct-10 Apr-11 Jun-11 Jul-11 Sep-11 Oct-11 Feb-10 Aug-11 Number of Attendances Seen within 4hr 4hr Wait Standard Source: A&E Data Mart, ISD Scotland
  • 7. Rate per 100,000 Population - S 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 ep - 09 O ct -0 N 9 ov -0 D 9 ec -0 Ja 9 n- 1 Fe 0 b- 1 M 0 ar -1 Ap 0 r-1 M 0 ay -1 Ju 0 n- 10 Ju l-1 A 0 ug -1 S 0 ep -1 0 O ct -1 N 0 ov -1 Major Rate D 0 ec -1 Ja 0 n- 1 Fe 1 b- 1 Major/Minor Activity - Scotland M 1 Minor Rate ar -1 A 1 pr -1 M 1 ay -1 Ju 1 n- 11 Major/Minor Activity Ju l-1 A 1 ug -1 S 1 ep -1 O 1 ct -1 N 1 ov -1 D 1 ec -1 Ja 1 n- 12Data Source: A&E Data Mart, ISD Scotland
  • 8. Rate per 100,000 Population - S 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 ep - 09 O ct -0 N 9 ov -0 D 9 ec -0 Ja 9 n- 1 Fe 0 b- 1 M 0 ar -1 Ap 0 r-1 M 0 ay -1 Ju 0 n- 10 Ju l-1 A 0 ug -1 S 0 ep -1 0 O ct -1 N 0 ov -1 Major Rate D 0 ec -1 Ja 0 n- 1 Fe 1 b- 1 M 1 Minor Rate ar -1 A 1 pr -1 Major/Minor Activity - 0-4 year olds in Scotland M 1 ay -1 Ju 1 n- 11 Ju l-1 A 1 ug -1 S 1 ep -1 O 1 ct -1 N 1 ov -1 D 1 Major/Minor Activity by Age Band ec -1 Ja 1 n- 12Data Source: A&E Data Mart, ISD Scotland
  • 9. Rate per 100,000 Population - S 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 ep - 09 O ct -0 N 9 ov -0 D 9 ec -0 Ja 9 n- 1 Fe 0 b- 1 M 0 ar -1 A 0 pr -1 M 0 ay -1 Ju 0 n- 10 Ju l-1 A 0 ug -1 S 0 ep -1 0 O ct -1 N 0 ov -1 Major Rate D 0 ec -1 Ja 0 n- 1 Fe 1 b- 1 M 1 Minor Rate ar -1 A 1 pr Major/Minor Activity - 5-9 year olds in Scotland -1 M 1 ay -1 Ju 1 n- 11 Ju l-1 A 1 ug -1 S 1 ep -1 1 O ct -1 N 1 ov -1 D 1 Major/Minor Activity by Age Band ec -1 Ja 1 n- 12Data Source: A&E Data Mart, ISD Scotland
  • 10. Rate per 100,000 Population - S 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 ep - 09 O ct -0 N 9 ov -0 D 9 ec -0 Ja 9 n- 1 Fe 0 b- 1 M 0 ar -1 A 0 pr -1 M 0 ay -1 Ju 0 n- 10 Ju l-1 A 0 ug -1 S 0 ep -1 0 O ct -1 N 0 ov -1 Major Rate D 0 ec -1 Ja 0 n- 1 Fe 1 b- 1 M 1 Minor Rate ar -1 A 1 pr -1 Major/Minor Activity - 20-24 year olds in Scotland M 1 ay -1 Ju 1 n- 11 Ju l-1 A 1 ug -1 S 1 ep -1 1 O ct -1 N 1 ov -1 D 1 Major/Minor Activity by Age Band ec -1 Ja 1 n- 12Data Source: A&E Data Mart, ISD Scotland
  • 11. Rate per 100,000 Population - S 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 ep - 09 O ct -0 N 9 ov -0 D 9 ec -0 Ja 9 n- 1 Fe 0 b- 1 M 0 ar -1 A 0 pr -1 M 0 ay -1 Ju 0 n- 10 Ju l-1 A 0 ug -1 S 0 ep -1 0 O ct -1 N 0 ov -1 Major Rate D 0 ec -1 Ja 0 n- 1 Fe 1 b- 1 M 1 Minor Rate ar -1 A 1 pr -1 Major/Minor Activity - 50-54 year olds in Scotland M 1 ay -1 Ju 1 n- 11 Ju l-1 A 1 ug -1 S 1 ep -1 1 O ct -1 N 1 ov -1 D 1 Major/Minor Activity by Age Band ec -1 Ja 1 n- 12Data Source: A&E Data Mart, ISD Scotland
  • 12. Rate per 100,000 Population - S 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 ep - 09 O ct -0 N 9 ov -0 D 9 ec -0 Ja 9 n- 1 Fe 0 b- 1 M 0 ar -1 A 0 pr -1 M 0 ay -1 Ju 0 n- 10 Ju l-1 A 0 ug -1 S 0 ep -1 0 O ct -1 N 0 ov -1 Major Rate D 0 ec -1 Ja 0 n- 1 Fe 1 b- 1 M 1 Minor Rate ar -1 A 1 pr -1 Major/Minor Activity - 70-74 year olds in Scotland M 1 ay -1 Ju 1 n- 11 Ju l-1 A 1 ug -1 S 1 ep -1 1 O ct -1 N 1 ov -1 D 1 Major/Minor Activity by Age Band ec -1 Ja 1 n- 12Data Source: A&E Data Mart, ISD Scotland
  • 13. Rate per 100,000 Population - S 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 ep - 09 O ct -0 N 9 ov -0 D 9 ec -0 Ja 9 n- 1 Fe 0 b- 1 M 0 ar -1 Ap 0 r-1 M 0 ay -1 Ju 0 n- 10 Ju l-1 A 0 ug -1 S 0 ep -1 0 O ct -1 N 0 ov -1 Major Rate D 0 ec -1 Ja 0 n- 1 Fe 1 b- 1 M 1 Minor Rate ar -1 A 1 pr -1 M 1 ay -1 Major/Minor Activity - 85 year olds and over in Scotland Ju 1 n- 11 Ju l-1 A 1 ug -1 S 1 ep -1 O 1 ct -1 N 1 ov -1 D 1 Major/Minor Activity by Age Band ec -1 Ja 1 n- 12Data Source: A&E Data Mart, ISD Scotland
  • 14. Emergency Admissions Proportion of Patients Admitted Following a New and Unplanned Return Attendance at EDs across Scotland by Age Band and Gender (April 2011 to March 2012) 70.0 60.0 50.0Proportion Admitted (%) 40.0 30.0 20.0 10.0 - 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ All Ages Male Female Source: A&E Data Mart, ISD Scotland