Case Streaming From NHS 111 & CCAS Contingency.

Introduction

In times of pressure, we may be asked to accept case streaming from NHS111. These are cases awaiting a clinical callback from 111, that they anticipate will not be called back within their disposition due to volume or staffing pressures. In addition, where we have capacity in the IUC service we may proactively offer streaming to support NHS111.

Our role in the process is to support NHS111 by accepting cases direct from their clinical queue where capacity allows.

The process varies for IUC Weekday service and IUC Weeknight and Weekend service.

Objectives of the procedure

The objective of this SoP is to explain the process of streaming and give guidance around its management.

The Standard Operating Procedure

Streaming may be agreed either by a request from NHS111 supervisor, or the operational lead at SevernSide offering to the NHS111 supervisor. The telephone number to contact the NHS111 supervisor is 0117 240 1111.  The operational lead at SevernSide must be the individual to make the decision on whether streaming is possible, and volumes we are able to accept should be agreed as part of the conversation.

Before implementing the streaming process we should consider current volumes, current staffing levels, any impending changes to staffing levels and how it may impact subsequent shifts.

Once agreed, the decision to start case streaming must be shared with all relevant operational and clinical team members of the Weekday Professional Line team on shift and the Shift Manager during the out of hours period, in order for this information to be passed on during handover.

All cases will be received electronically – this may be directly to the advice queue, or into the despatch queue.  Cases will have a speak to 1hr disposition and will not have had any clinical input so far.

The operational team should monitor the dispatch queue for any streamed cases, and then move to the advice queue.

Any cases received which are not relevant for our service should be passed back in the usual manner.

In the out of hours period we are profiled on the DoS already to receive all relevant cases so once agreed we do not need to amend the DoS , however in the weekday 8 – 18.00 period we need to activate this option (see below process).

Activating/deactivating case streaming Monday – Friday 08.00 – 18.00

As we are not profiled to automatically receive these cases during this time period, we need to activate, and deactivate case streaming. It is essential the below process is followed otherwise this will not happen.

A maximum of 5 cases per hour can be accepted between 09.00 – 16.00. All cases need to be received by 16.00 that day, after this time we will be unable to accept any further streamed cases.

Once streaming has been agreed, the operational lead (or agreed operational individual) must email the DoS  (Directory of Services) team to advise of the agreements so this can be amended on the DoS. This information should be emailed to

Dosteam.southwest@nhs.net 

With the wording:

‘Could you please add DX11 to the Severnside 24/7 CAS (Service ID – 2000014984) and we will update you when it needs to be removed’

At 16:00 hours, or before if demand exceeds capacity, the operational lead will send a request to the DoS team to turn this ‘off’ in order to no longer receive streaming.  Please do this by sending an email with the following wording:

‘Could you please remove DX11 from the Severnside 24/7 CAS (Service ID – 2000014984)’

The DoS team do not manage how many cases are sent through streaming, this should be agreed with the Clinical Supervisor at Practice Plus Group.  However, if the disposition is profiled, it is possible for cases to be passed through.

If admission call volumes increase and there is no longer capacity to manage case streaming, the clinician must advise one of the operational team working who should call the NHS111 supervisor immediately to advise no further cases can be accepted and update the operational team.

An email must be sent to the DoS team to advise when streaming has been stopped to prevent further cases being received, regardless if this is due to capacity or time of day.

NHS111 Contingency – CCAS

All NHS111 providers have contingency plans in place for when there is disruption to service. This is covered in the Business Continuity plan.

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