CQC says COVID has been ‘catalyst for change’ in emergency care

A new report from the Care Quality Commission (CQC) highlights good practice in urgent and emergency care services.

The Commission said it found some “inspiring stories” of how the pandemic has served as a catalyst for change. 

The report highlights over 40 examples of schemes that appear to be making a difference including:

• West Yorkshire and Harrogate, Suffolk and North East Essex, and Cornwall and the Isles of Scilly, all introduced ‘passporting’ of staff between NHS trusts. An NHS competencies passport enabled staff to move between providers within a system more easily – the aim was to reduce gaps in staffing and improve patient care

• GPs at a Northamptonshire practice had regular calls with the ambulance service and worked together on patient cases to avoid unnecessary ED attendance

• In Herefordshire and Worcestershire, same-day emergency care virtual follow-up clinics were set up for patients who were too vulnerable to return to an ED

• In Cheshire and Merseyside, the Core 24 service meant that there was permanent mental health care in an ED

• Suffolk and North East Essex launched an initiative called Home, But Not Alone. A phone line was open 9am to 5pm, seven days a week, to help on topics including food, medication, loneliness and isolation.

• The public health team in Northamptonshire established an equality impact framework, looking at groups that may have been disadvantaged.

The organisations taking part in the review were:

• Cheshire and Merseyside Health and Care Partnership
• Hampshire and the Isle of Wight
• Cornwall and the Isles of Scilly
• Northamptonshire Health and Care Partnership
• Herefordshire and Worcestershire
• East London Health and Care Partnership
• Suffolk and North East Essex
• West Yorkshire and Harrogate

The report says many systems accepted that usual governance and funding considerations came secondary to meeting the needs of people requiring urgent and emergency care during a crisis. 

The CQC noted: “Providers have worked together to ensure urgent and emergency care services and pathways adapted quickly and safely, and that people received the right care, in the right place, at the right time”.

The key themes covered in the report include:

• keeping people safe
• public messaging
• supporting people’s mental health needs
• tackling inequalities
• including adult social care in UEC planning
• effective governance
• keeping staff safe
• good use of technology
• supporting children and young people
• capturing system learning

The review team also spoke with adult social care providers, including care homes and domiciliary care agencies, to understand their experience of working with urgent and emergency care services. 

In several areas, reviewers heard how the sharing of expertise, use of technology and monitoring equipment and sharing of staff helped to improve remote triage and prevent people being admitted unnecessarily.

The report’s authors say it is vital that the health and social care system does not lose the hard-learnt lessons of this crisis.

But CQC is pausing further provider collaboration reviews and will restart once the crisis is over.

A full copy of the report is available here