National Six Goals Programme Update
The following actions were taken forward in April:
- Six Goals Programme investment plan approved;
- Six Goals Programme Planning and Implementation guidance for Health Boards was distributed, with ‘ceiling budgets’ confirmed;
- A Six Goals Improvement Triumvirate Team (ITTs) recruitment framework was distributed to Health Boards;
- A national programme launch event was held on 27 April;
- Simon Jones recruited as Senior Programme Manager
Key milestones for Q1 2022/2023:
- Health Boards to submit ITT recruitment plans by end of week commencing 2 May 2022;
- First set of investment cases against Six Goals Programme Innovation and Delivery Fund to be considered at Integration Group meeting of 12 May 2022;
- Health Boards to establish local Six Goals governance arrangements by end of May 2022;
- Health Boards to submit Six Goals programme plans (inc. investment plan for 2022/2023) by end of Q1.
Six Goals for Urgent and Emergency Care Programme Director Appointment
Earlier this week, Nick Wood, Deputy Chief Executive NHS Wales confirmed Richard Bowen’s appointment as the Six Goals for Urgent and Emergency Care Programme Director.
This appointment will provide the leadership to deliver this important programme, with some of the initial key priorities including bringing together a national Six Goals Programme plan with refined objectives and outcomes; the creation of a Six Goals Programme Management Office (PMO); and overseeing robust implementation of new Six Goals Improvement Triumvirate teams embedded within Health Boards.
Workforce, education, training and development work-stream
A Six Goals Workforce Enabling Group was established in January 2002 to ensure the delivery of six goal priorities is supported by excellent education, training and development.
The Group, which includes representation from each of the Six Policy Goal Workstreams, Welsh Government, Social Care Wales, Directors of Workforce & OD, WAST and CHC, meet on a monthly basis.
An initial workshop was held in October 2021 to identify initial priorities and a further workshop was held in March 2022 to identify those longer term priorities.
Progress to date has included:
- Development of an Urgent Care Practitioner Competency Framework
- Scoping of a Remote Clinical Decision Making Education Pathway
- Developing Universal Guidance for Vulnerable Groups
- Advanced Paramedic Practitioner Education Commissioning
- Publication of Integrated Care Compendium
Next steps for the work-stream include agreeing deliverables i.e. Education / Workforce Design/ Service Development which are aligned to the key themes outlined within the Workforce Strategy for Health and Social Care.
Goal in Focus
This month’s ‘Goal in focus’ is Goal 4: Rapid Response in a physical or mental health crisis.
Stephen Harrhy, Chief Ambulance Services Commissioner and Lead Director for Goal 4 provided the Board with an in-depth description of the objectives, milestones and outcomes. A set of proposed measures was endorsed by the Board and will be used from this point to track progress.
Some key developments include:
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Optimising ambulance conveyance of 999 patients –Procurement and implementation of Emergency Communication Nurse System (ECNS) – go live date 17.5.22. Temporary expansion of clinical support desk (CSD) staffing with an additional 36 WTE and funding for 6 WTE Mental Health Practitioners. Conveyance volumes to Emergency Departments have begun to reduce;
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Optimising ambulance response to support better clinical outcomes - Implemented a range of short-term actions to bolster response capacity in Q4 2021/22, progress and implementation of Physician Triage and Streaming (PTAS) in each Health Board and Handover ‘red lines’ agreed;
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All Wales escalation framework and demand management plan - draft framework developed to focus on areas of highest risk to patients and public, maximise resources for acute triage, primary and secondary care assessment and discharge/step down, release bed capacity, maintain scheduled care activity and minimise ambulance patient handover delays;
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Emergency Department Quality and Delivery Framework - Clinically led development of 5 step model of care and 20 Care Standards (evidence based), Operational Arrangements for Ambulance, Handover & Triage agreed by Chief Medical Officer, Chief Nursing Officer and Medical Directors, Design & Implementation of ED Experimental Measures including
- Time to triage,
- Time to clinician
- Outcome of attendance - This element focus on the outcome of the patients visit.
Priorities
Some of our priorities over the next 12 months are:
- Secure funding for continuation of ECNS (Bid submitted to Integration Group April’22)
- Implement revised rosters across Wales that match capacity to demand in 2022/2023
- Secure funding for Cymru High Acuity Response Unit (CHARU) – improving outcomes for the sickest patients
- Establish a National Clinical and Operational oversight group
- Data analysts supporting development of Triggers - local, regional and national triggers
- Timeline for development & implement of 20 ED Care Standards using Pathway Improvement Projects (PIPs) by April 2023:
- Implementation of Ambulance Handover & Triage Care Standard Improvement Project.
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Last month we held the official launch of the Six Goals for Urgent and Emergency Care programme and were joined by over 315 delegates at a virtual event. We would like to thank everyone who attended for their support and contribution to the successful delivery of this event.
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All aspects of the event are available to watch back on demand for 30 days, under the ‘videos’ tab, including the Health Minister’s keynote speech on the expectations for the system and an opportunity to hear from Nick Wood, Deputy Chief Executive on the Six Goals programme: Accelerating progress locally and regionally.
The agenda also included a series of breakout sessions, a copy of the slides from these sessions are also available under ‘resources’ – these sessions were not recorded to encourage an open discussion. A summary of the emerging themes will be made available in next month’s newsletter.
If you attended the event, we are also keen to hear your feedback about what you thought worked well and where improvements can be made for future events. Please could you spare a few minutes to answer our post-event poll.
If you would like to receive this bulletin in Welsh, please email SixGoals.UrgentAndEmergencyCare@gov.wales
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