Kettering Emergency Dept

The issue:

Kettering General Hospital (KGH) found itself with an Emergency Department (ED) service that was too small, too limited in scope and unsuited to the spectrum of urgent care needs of its patients. The existing Emergency Department opened in 1994 to serve 50,000 attendances per year; this has since increased by 40%.

KGH realised that simply focusing on A&E does not recognise the scale and complexity of the urgent care needs. What is needed is a broad-based, multi-agency solution which provides a range of services.

Our unique approach

Essentia Trading engaged with the clinical team at KGH to crystallise their vision of a model that would challenge traditional boundaries, ultimately creating the Urgent Care Hub (UCH) model. The UCH concept provides an innovative and forward-looking solution, as it extends the A&E model to include all urgent care services – not just acute healthcare, but primary care, voluntary services, Social Services and Mental Health. This “single front door” and multi-agency approach aligns perfectly with the vision outlined in the NHS ‘Five Year Forward View’.

Essentia’s multi-disciplinary team gave us the breadth of industry skills and expertise to develop this concept into a series of real-world, operationally-viable and deliverable solutions, within the framework of a Strategic Outline business case (SOC):

  • Clinical strategy expertise and stakeholder engagement identified the core benefits of an Urgent Care Hub (UCH).
  • An estimate was drawn up of the floor space required to realise the new UCH.
  • Initial floor space estimates were mapped onto the KGH site; indicating the possible locations in which the UCH could be located.
  • Initial investment costs were estimated for a range of capital options.
  • Preliminary revenue analysis indicated that the on-going revenue implications of costs of around £39m could be offset by service efficiencies and productivity.

The outcome

Investment in the Urgent Care Hub was ratified by the Trust Board and Monitor.

The next step is to further develop this innovative model of care across the health economy, in conjunction with partner agencies. If successful, construction could begin towards the end of the 2016/17 Financial Year, with site works completed 18-24 months later, depending on the solution chosen.

The term ‘whole systems approach’ is typically over-used and under-delivered within the NHS and a lack of integration across health and social care is the deep rooted cause of many of the problems facing the service today. The Kettering project is a shining exception and, with an ambition to redesign the whole urgent care pathway, should be the shape of things to come.

John Kelly, Director of Healthcare Planning at ETL