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Flow Navigation Hub – The key to the Right Care, Right Place model.

Our Flow Navigation Hub has changed the way we deliver unscheduled and emergency care.

Before you visit Accident & Emergency, our hub will assess you. They decide whether you need a face to face appointment with your GP, self-care advice, or to see a specialist.

Flow Navigation Hub – The key to the Right Care, Right Place model. 

In December 2020 we launched the Right Care, Right Place model of care in line with the rest of Scotland’s health boards. This model has been designed to enhance the efficiency we’re able to deliver care to patients and to ensure that those who would normally attend our Emergency Departments without life threatening illnesses, are appropriately signposted before that happens.  

The model works by encouraging patients to always first call their GP, or, to speak to NHS 24 on 111, before they attend an Emergency Department (unless their condition is life-threatening).  

Following this contact, their GP or NHS24 will signpost them or refer them as appropriate. When NHS24 decides a patient should be further assessed by a clinician, they are referred on to our specially designed ‘Flow Navigation Hub’ which facilitates their onward care and determines the appropriate pathway for them.  

How does the Flow Navigation Hub work? 

The FNH works by receiving urgent care referrals made by NHS24 for patients that have been deemed as requiring further clinical assessment and have been identified as clinically ‘safe to wait’.  

Referrals are then scheduled into a designated time slot for a Virtual Consultation to be carried out by clinicians in the FNH alongside the virtual MIU, who assess the patient and determine next steps.  

What does the Flow Navigation hub look like? 

The Flow Navigation Hub is based at the QEUH Campus and is operates seven days a week by a mixture of Doctors and ANPs, with support from the Administration Hub. As it grows, it will be supported from staff across sites. 

How do the assessments take place? 

Once a time slot has been appointed for the patient referred by NHS24 for a virtual consultation, the clinical staff in the FNH (or Minor Injuries Units) will carry out a clinical assessment of the patient using either telephone or Near Me. 

What are the outcomes?  

Patient outcomes from the virtual consultation by the FNH or MIU fall into a number of categories which can include:  

  • Discharging the patient 
  • Booking the patient for a face-to-face assessment in an Emergency Department or a Minor Injuries Unit 
  • Referring patients to their GPs 
  • Specialist referral pathway: We are currently exploring new pathways to refer patients directly into specialist services through the FNH, however, these are not currently in place yet (as of 15 Feb 2021) 

How will we know if it’s working? 

Since launching in December, the FNH alongside the virtual MIU has now processed more than processed more than 2500 patients (as of February 2021). These early figures are encouraging, demonstrating that between 29% and 40% of those referrals each week are being successfully assessed through virtual consultation, with no further action required. As the FNH continues to integrate with the wider system, in the longer term we would hope to see this positive impact help support our EDs to focus on caring for those who need it the most.

The role of the FNH will continue to grow in coming weeks and months, as the Right Care Right Place model of care is promoted nationally and we will shortly be launching an online resource to showcase the FNH and how it works.

What is the long-term plan the Flow Navigation Hub? 

As the new model beds in, the Scottish Government, alongside all local boards including NHSGGC will continue to promote the Right Care, Right Place to help encourage any patient who has an urgent but non-life threatening condition to call NHS24 or visit their GP before presenting at ED.  

This will mean as awareness increases, more patients will be filtered through the FNH from NHS24, and we will be able to minimize unnecessary ED presentations and ensure patients get the right type of treatment from the most appropriate service.  

 

Last Updated: 20 April 2021