Support for challenged health and social care communities

We offer a range of support to health and social care systems to facilitate improvements to the urgent care pathway.

100% challenge

Here at the UM unit, we have designed and created the ‘100% Challenge’ to support Trusts to rapidly improve performance towards the 95% standard, without impairing patient care or staff experience.

The aims and objectives of the 100% challenge are:

  • To test the steps, resources and behaviours necessary to deliver consistently high performance, as measured by the ED 4-hour standard
  • To improve patient safety by increasing the hospital performance towards the 4-hour standard
  • To facilitate care at the right time in the right place
  • To identify obstructions to patient flow within the health and social care system and to work collaboratively with Trust staff to remove these quickly and safely
  • To test new ways of working without the need for formal ‘case for change’ proposals

How is the 100% Challenge delivered?

The “challenge” event runs over 3 days; prior to this there is detailed activity modelling using predictive analysis. The activity modelling highlights key areas of improvement and supports the staff engagement events.

Day 1
Our members from the UM Unit clinical team and Trust staff review all “delayed” patients and deliver actions to expedite delayed assessments and investigations.
Day 2 – The Challenge Day 12 midnight – 12 midnight.
We work alongside Trust staff in key areas. A control room is operational with 2 hourly meeting focused on pro-actively managing the site, identifying any obstructions to flow and planning actions to mitigate risk.
Day 3 – Debrief
There is a formal feedback session for all Trust staff to consider lessons learned and the effect of the challenge on performance. This is followed by a formal report.

Non-elective Pressures and Performance review

The UM Non-Elective Pressures and Performance Review aims to inform A&E Delivery Boards and/or Network Boards about the possible contributions to reduced performance at their local Trusts. This supports the development of focused action plans to improve and sustain acceptable levels of ED performance, particularly over the winter period.

In our experience, ED underperformance is rarely attributable only to ED internal issues, therefore we examine the impact of process and pathways across the entire patient journey and how the arrangement of services is likely to contribute to current and future performance challenges.

We use a blend of national returns, national SitRep submissions and local data extracts to understand the key contributions to whole system performance. Data analyses are supported by a 2 day observation period at the Type 1 ED hospital site. Whilst data illustrates where opportunities for improvement arise, it is observation that illuminates the cause and effect and why systems underperform; for example, data shows activity and performance but fails to illuminate relationships, working practices, rotas and arrangements for care.