Way Forward: High Intensity Use of Urgent and Emergency Care Programme
Download (PDF 269.8 KB)Summary of report content
Healthwatch Wirral report on the impact of their Way Forward programme which aims to support people who frequently attend urgent and emergency care, typically as a result of long-term conditions, health anxiety, trauma, and broader social determinants of health. The service provides personalised, community-based coaching and system navigation to reduce avoidable use of Emergency Department (ED) and non-elective admissions (NELs), while improving confidence, wellbeing and access to appropriate services.
Financial outcomes
AEmergency Department attendances of people who received interventions reduced by 52.7% on average. Non-elective admissions reduced by 52.88%.
There was £107,070 cost avoidance from reduction in emergency department attendances. 3 £22,761 non-elective admission cost avoidance, totalling to £129,831 (does not include full NEL cost avoidance, or any ambulance conveyance cost avoidance)
The budget for 15-month project: £65,075 (£52,060 per year). Net savings (£129,831−£65,075) = £64,756, (99.5% return on investment). For every £1 invested, £1.99 was saved.
Key learning
Model and delivery: positioning must be consistently preventative, community-based, and non-clinical; clinical delivery in hospital settings risks disengagement and unmet outcomes – becoming treatment rather than prevention.
Pathway gaps: the cohort has highlighted potential gaps in provision for cardiovascular and respiratory exacerbation management and post-diagnosis support, and necessity for connecting hospital patients with health anxiety support outside of secondary care settings.
Continuity matters: breaks in support can contribute to re-escalation and increased avoidable service use for some individuals.
Measurement opportunity: regular attendance data, a live attendance tracker (including NWAS call/conveyance data) and inclusion of post-closure outcomes would strengthen evaluation and inform commissioning decisions.
Long term commissioning: Initial commissioning period of 15-months too short to establish effective system reductions and continuity of support to individuals.