Bella Scantlebury is leading research in rural and coastal healthcare. The National Institute for Health and Care Research (NIHR) funded ELEVATE project is exploring innovative models for delivering urgent and emergency care in these underserved regions.
Background:
Demand on Urgent and Emergency Care (UEC) services is felt throughout the NHS. However, rural and coastal communities face unique challenges. The importance of funding research and developing bespoke solutions to address health and wellbeing in rural and coastal communities has been identified as a national priority – Chief Medical officer’s 2021 annual report. We do not know how rural and coastal areas are responding to NHS England’s UEC recovery plan or how best to organise and deliver UEC care in these areas.
Aims:
To identify and evaluate innovative models of UEC in rural and/or coastal communities in England, including their impact on patient care, clinical outcomes, workforce and use of healthcare resources.
Methods:
The project consists of three work packages (WPs):
WP1: A desktop review of organisational and policy documents, interviews with national, regional and local leads and stakeholders, focusing on rural and/or coastal areas. The output will be a national service map outlining UEC provision in rural and coastal communities.
WP2: Using the national Emergency Care Data Set (ECDS) from NHS England, we will develop new bespoke ED performance metrics. We will use quasi-experimental to assess the impact of new UEC models (identified in WP1) on health and process outcomes, using standard metrics (e.g. admission rates, time to triage and discharge) and bespoke metrics (e.g. transfer avoidance, sensitivity and specificity of triage).
WP3: Up to 12 case studies of UEC models in rural and coastal communities in England. We will interview and observe patients, carers, health care professionals within case sites. Personnel from other local health and care services (e.g. Ambulance staff, social care, primary care) will be interviewed but will vary according to UEC model composition.
How this research will help:
The output will be an in-depth understanding of how and why different UEC models influence patient clinical outcomes, experience, resource use and workforce.