Integrated Urgent Care
What is integrated urgent care (IUC)?
IUC is a collective term that brings together all same‑day, unplanned urgent care services outside Emergency Departments (EDs), including Urgent Treatment Centres (UTCs), GP Out‑of‑Hours (OOH), Clinical Assessment Services (CAS), and walk‑in centres/minor injuries units.
Why does it need to change?
Across Lancashire and South Cumbria there is substantial variation in delivering IUC services, with 12 different commissioned contracts being delivered by eight different providers. This has created the following:
- Wide variation in access, quality, workforce, digital maturity, and cost.
- Outdated model not aligned to post-COVID demand or national policy.
- Data gaps and poor integration driving inefficiencies and poor experience.
- A&E attendances and emergency admissions growing faster than the national average.
- High levels of low-acuity demand suitable for community care.
- Increasing pressure on emergency departments and general practice.
You can read more in our Case for Change – the link is at the top of this webpage.
What do we want to achieve?
Our overarching ambition is to design a consistent integrated urgent care service that is accessible to all and meets the current and future needs of the population. We want to do this by introducing a single clinical operating model delivered in collaboration within ‘place’ footprints across Lancashire and South Cumbria that allows freedom to deliver flexibly in different areas based on local population needs.
A new clinical model will include people suffering from moderate to low levels of illness or injury and will:
- operate 24 hours a day
- be a digital first 'consult and complete' operating model (meaning patients will receive a complete episode of care concluding with either: advice, a prescription, or an appointment for further assessment or treatment)
The final model should enable:
- a shift to digital-first, clinically integrated, neighbourhood-based, 24/7 care
- emergency departments to be a destination of need, not the default access point
- those with a moderate illness and /or injury to be treated within an urgent treatment centre setting
- those with a less severe illness to be treated within a neighbourhood setting
What has happened so far?
We co-designed our design principles that have become the backbone for all of the team’s work to improve urgent care. These are:
- More urgent care within a community setting
- Right care, right place, right time
- Pathways to 24hr access
- Easier navigation for patients and professionals
- Accessible, secure, connected IT systems
- Equitable access
- Appropriate waiting times
- Stakeholder engagement
- Joint working and integration
- Efficiencies
- Reduce health inequalities
- Workforce development
You can read more about how these were co-designed in the ‘Listening to communities’ reports:
Over the last two years we have been listening to feedback from our patients, members of the public, our Influence Panel, colleagues and providers and all of the insights they have provided are being used to begin to design what our future model of integrated urgent care could look like, along with a longlist of possible options for consideration.
What are the next steps?
Work is now being undertaken to pilot some new ways of working with our current urgent care providers to see what is feasible for the future and work out where we may need to make changes to our services in order to improve patient experience and ensure our services are resilient in meeting the needs of our future population.