Currently urgent care services are provided by a range of organisations in Devon, providing a number of different options for people to use. Some of these duplicate each other, or have a slightly different offer which makes it difficult for the public to be sure they are using the right service to meet their health needs. There is often a difference of opinion between the public and the service providers as to what constitutes an emergency or an urgent healthcare need. Working as a partner with providers, commissioners have a desire to develop a more integrated approach to urgent care which increases patient satisfaction and safety and delivers a cost effective model of provision. Working with providers commissioners expect to create the conditions to develop a more integrated approach to urgent care which increases patient satisfaction and safety and delivers a cost effective model of provision. The commissioners are keen to develop a lead accountable provider model for urgent care. We acknowledge there may be many options for the future model and partnerships, including single lead accountable providers, alliances, consortium's, single provider etc. We wish to do this to:

— Create an environment which enables services to align themselves to reduce duplication of delivery and consistency of governance approaches.

— Creates a better environment to align outcome indicators and reduce perverse incentives in the urgent care system for individual providers.

— Give a single lead accountable provider (with its subcontractors) the ability to construct an overall pathway of care and incentives that provide the commissioner with the outcomes that they want.

— Encourage collaboration in the urgent care landscape with the right levers and incentives in place. Providers can directly work together, supported by the contracts between them, to ensure the pathway is as efficient and effective as possible. The prime contractor model is sufficiently flexible to accommodate a range of payment mechanisms and incentives.

— Meet the economic imperative to deliver significantly better health care outcomes for the same resource.

— Allow commissioners to concentrate on outcome measures and not micro manage provider services.

— Allow a more flexible approach to payment mechanisms.

Further information can be found in the Urgent Care in the Community sections in the following documents:

— Strategic Framework;

— Case for Change;

— Engagement Report.

These documents provide the strategic direction for community services, including design principles, and therefore the context and ambitions that the Clinical Commissioning Group is setting out to achieve to best meet the needs of patients'. They can be accessed at: http://www.newdevonccg.nhs.uk/involve/community-services/101039