UEC System Actions this week
Dear Colleagues,
We know that the urgent and emergency care system is likely to be impacted over the course of the week due to the forecast increase in temperature over the next few days and the potential increase in weather-related presentations. We have seen a number of alerts relating to high temperatures and pollution and have seen increased activity across the weekend, particularly for the London Ambulance Service.
I am sharing this note to ensure we are collectively clear on the actions required in response. I recognise that system leaders will already be progressing many of these, and this is not intended to rehearse the obvious, but rather to provide a consistent frame across London.
The priority for this week is to maximise safety and manage the potential increase in demand. We recognise systems will be enacting plans to manage pressures and would like to reiterate the need to work collaboratively across local authority, primary care, community, mental health, ambulance and acute partners. Ensuring the safety messages and alert notifications are being shared with the target audience, enabling proactive escalation processes across pathways and the implementation of necessary response plans. As a region, the Ops team will continue to monitor safety across the UEC pathway and support escalation where required.
LAS is currently operating at REAP Level 4 and has moved to Clinical Safety Escalation Plan Level 4 to maximise safety, manage the high volume of 999 contacts, and reduce waits for emergency ambulances. They have also:
- Released additional funding and incentivised shifts to meet forecast demand.
- Arranged mutual aid from both SJA and PAS on a temporary basis.
- Hot weather and welfare vehicles are being deployed.
- Increased NHS 111 provision to further improve H&T and to reduce pressure on the UEC system across London.
To help manage demand over the next few days, we ask systems to support with the following:
System partners:
- Only refer patients to 999 where it is absolutely clinically necessary or in the case of a life-threatening emergency.
- Only refer patients to 111 where there is an immediate urgent need; otherwise, advise use of 111 online or local pharmacy support.
- Ensure non-clinicians do not refer patients to 999 or 111 as an alternative to primary or community care unless it is a life-threatening emergency.
- Utilise urgent community response teams and alternative care pathways, including pharmacies.
ED sites and other receiving sites, to support response to high-acuity patients in the community:
- Support W45 handovers.
- Be prepared to support the rapid-release of an ambulance protocol, deployed only in response to an identified life-threatening emergency where no other resources are available.
- Prevent patients being held on the back of ambulances in these extreme weather conditions.
Please can you ensure the above is communicated appropriately across your systems.
Many thanks for your ongoing support.
Edmund
Edmund King
COO
NHS England – London