We need your help to respond to extreme urgent and emergency care pressures

A message to health and care colleagues in our Partnership.

Dear colleague,

We recognise the pressures that primary care and care homes are under and appreciate all that you’re doing to help keep patients safe and well. We know your actions are helping to reduce impacts on the wider system. However, we now need your help to support colleagues working in urgent and emergency care. The health and care system is experiencing extremely high levels of demand and all hospitals across West Yorkshire are under significant pressure. Extra capacity beds are in use and most elective care has been cancelled.

Emergency departments have very high volumes of attendances resulting in over-crowding, long waits to be seen and delays for people requiring admission. All wards have extra patients being cared for on trolleys and/or in corridor areas. This means hospitals are not able to offer optimum care for people at this time. It is therefore very likely that – unless people require highly specialist care that cannot be provided outside a hospital setting – they will have a better, safer experience if they can be managed in their usual home environment.

A system-wide meeting has taken place this morning and has agreed co-operative actions to be taken to mitigate the situation as far as we are able.

Please help us by managing demand for urgent, on-the-day needs.

We ask GP practices to:

• prioritise urgent and same day needs. Step down routine and non-urgent to facilitate this.
• “see before send”, which means increasing the number of urgent, on-the-day, face-to-face appointments across your GP practice teams. No patient should be referred to hospital without a face to face clinical assessment
• consider virtual ward or urgent community response wherever possible (teams will have extra capacity).
• consider whether any staff can support LCD, who have considerable numbers of patients waiting for clinical call back
• work with your colleagues in care homes to limit the number of people sent to hospital from those places of residence, and that you support them to receive people back from hospital.

Any public messaging on your websites or telephone answering machines should encourage people to use NHS 111 online (www.111.nhs.uk). For those unable to access online services, please encourage people to call NHS 111.

We ask colleagues in care homes to:

• if you have residents who are in hospital, make proactive contact with the ward to establish whether their needs could be better met in the care/nursing home environment.
• manage patients with COVID or flu in accordance with infection, prevention and control protocols
• be aware that COVID positive residents can return from hospital to their usual place of residence (link to CQC guidance)
• if patients require clinical review, consider all possible alternatives to hospital assessment (GP, virtual ward or urgent community response) and only consider 999 or referral to hospital in a critical or life-threatening situation
• care for residents who are at end of life in the care home or nursing home wherever possible to provide optimum comfort and dignity for the resident and their family
• use all available capacity in your home and be prepared to accept residents in accordance with discharge to assess protocols.

Thank you for your support to help us deal with these exceptional pressures. We appreciate all that you continue to do and recognise that postponing planned activity will naturally have an impact on your activity and pressures on primary care in the New Year.