Archived: Primary Care ED Streaming Service

Updated 15 August 2018

Care UK is the registered provider of the Primary Care Emergency Department (ED) streaming service. The management and administration of the service is in the Primary Care building next to the hospital (CHUFT) within the offices occupied by the other services provided by Care UK. The provider employs 28 staff members with roles ranging from GPs to managers, administrators and receptionists. Staff employed at the service work in shifts of six hours to cover the service availability from 10am in the morning until 10pm at night, seven days a week.

The clinical ED streaming service is in the A&E Department comprising a waiting room, reception desk, and consulting room for the GP. We visited both the A&E ED streaming service within the hospital, A&E department and the management and administrations offices run within the Primary Care building next door to the hospital.

The Primary Care streaming service is an NHS England initiative to stream appropriate patients away from the A&E department at the hospital with a primary care medical need, if their healthcare needs are not deemed as urgent. The service in Colchester has been in operation since October 2017. The service is not intended for people to use as an alternative to their GP, or the Walk-in-Centre (WiC). The hospital and the Primary Care streaming service provider meet monthly to assess how the effectiveness of the and to improve the delivery of the service to meet local population needs.

• The first contact at the A&E department is managed by the hospital where a trained clinician triages and streams people into the most appropriate service to meet their needs.
• Streaming is performed as soon as possible, within 15 minutes of the patient’s arrival.
• Streaming typically involves taking a brief history and performing basic observations if appropriate. This information is used to support triage prioritisation.
• Early warning scores are part of the assessment and designed for patient safety to be paramount. The initial assessment process is designed to improve the overall quality of care provided for patients and add value to the patient’s experience. By providing early assessment this ensures the patient is prioritised to see the most appropriate clinician to meet their need.

Updated 15 August 2018

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at the Primary Care Emergency Department Streaming Service on 10 July 2018 as part of our inspection programme.

At this inspection we found:

• The service had effective systems to manage risk and safety incidents to reduce them happening.
• The service reviewed the effectiveness and appropriateness of the care it provided monthly to ensure care and treatment was delivered according to evidence-based guidelines.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• The service provided care and treatment within Emergency Department Streaming Service guidelines and timescales for local population needs.
• Patients we spoke with in the service waiting room were positive about the service.
• There was a strong focus on continuous learning and improvement from monitoring and audit at all levels of the organisation, and their shared partnership with the A&E departments at the Colchester Hospital University Foundation Trust (CHUFT).

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice