Improving access to secondary care

Primary Care | Secondary Care | Support Services


Service user feedback in Northumberland showed people often experienced frequent delays accessing services at a time of crisis, and were bounced around the system. Delays in receiving the right support meant situations escalated, requiring involvement of A&E, ambulances and the police.

Who and where?

Northumberland Tyne and Wear NHS Foundation Trust Initial Response Service (IRS) for Sunderland, South Tyneside and Gateshead. 

Sunderland CCG and South Tyneside CCG  supported the project


The Trust radically transformed referral routes and pathways by introducing an Initial Response Service (IRS). IRS is a single point of access, operating 24/7 for all urgent and routine referrals. Teletriage and telehealth was used to enable and embed the changes.


Service users, carers, commissioners and providers worked in partnership to redesign pathways. A programme of staff engagement to support large scale change was implemented. The project used quality improvement tools based on LEAN including Value Stream Mapping and Rapid Process Improvement.

Our success

Surveys and evaluation showed that 100% of service users were happy to recommend the IRS service to family and friends. Staff feedback was positive. Clinician administration time was released, enabling them to focus more on face to face patient time.The Trust reduced bed capacity by 90 beds.

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