Clinical Assessment Service

About the Clinical Assessment Service

A triage system delivered by call handlers inevitably errs on the side of caution. A trained clinician led service is more likely to appropriately refer and manage.*
*University of Sheffield study, 2013.

Across Lincolnshire, providers, commissioners and the voluntary sector came together to establish CAS, our Clinical Advice Service, to ensure that more of Lincolnshire’s population connected to qualified clinicians when they need to. CAS is led by LCHS.

HOW DOES IT WORK?

Throughout the day and night, LCHS’ team is working across our urgent care teams, busy in our OOHs centres. They are also on hand to call patients who need help, at the request of paramedic crews, 111, care homes and many others.

After speaking to the patient, the CAS team use their years of study and experience to decide what the best course of action is. This could be issuing a repeat prescription, organising a much needed ambulance or a referral to LCHS’ Home Visiting team. CAS exists to get to the right solution quickly – this means no unnecessary travel and waiting time for the patient and no unnecessary use of acute services.

We’re really proud of Lincolnshire’s CAS. We were one of the first regions to innovate and introduce a CAS, and now we are seeing this model of care being mandated to all, as a gold standard of care. So far, CAS has achieved:

• 36% of CAS’ calls are ended with advice given, but no need for any further NHS contact. This year, that’ll mean approximately 35,000 patients not visiting A&E or calling an ambulance or using a hospital bed in Lincolnshire
• During Christmas 2016 the UK’s acute sector was experiencing an all time high demand. CAS’ call rate was 250% its norm, yet there was no increase in attendance in Lincolnshire’s acute hospitals – calls were dealt with by our team there and then.
• In its initial 6 months (of partial activity), CAS saved over £600,000 in Lincolnshire’s NHS (the approximate cost of the 35,000 visits that didn’t happen).
• Patients agree: Andrew, 67 said “It was great to be able to talk to a GP quickly when my back went and I was in agony. I couldn’t get up or move but I knew I didn’t need an ambulance. The doctor was calm and reassured me that I would get help with the pain. A Nurse visited and gave me an injection and organised some help for me. Within a few weeks I was back on the golf course!”

THE FUTURE:

This spirit of innovation remains:

• we have plans to increase the amount of capacity we have to make calls
• we’re adding pharmacists to the CAS staffing so that more repeat prescriptions and medication queries are dealt with outside of A&E
• we’re establishing a direct line for care homes to reduce their use of acute services
• we’re increasing the support we offer to ambulance crews on scene, and other professionals that are also working their hardest to keep the NHS on top.