What is No More Silos?

No More Silos is a plan, originally published by Health Minister Robin Swann in October 2020, to maintain and improve urgent and emergency care services across Northern Ireland, in anticipation of the Urgent and Emergency Care Review.

Consultation on the Urgent and Emergency Care Review closed on 1 July 2022, drawing out three key strategic priorities:

1. Creating an Integrated Urgent and Emergency Care Service
2. Capacity, Co-ordination and Performance; and
3. Intermediate Care, a regionalised approach

Implementation of these priorities is being overseen by the Urgent and Emergency Care Implementation Board within the Department of Health, with the No More Silos Programme having responsibility for the implementation of Strategic Priority One: Creating an Integrated Urgent and Emergency Care Service.

Overarching Principle of No More Silos

Many of those patients who attend Emergency Departments may have urgent conditions which, while serious, are not immediately life-threatening and could be managed better by another service elsewhere.

The No More Silos Programme seeks to protect Emergency Departments for emergencies, whilst providing alternative services/pathways of support for urgent but not life-threatening conditions.

The goal is to achieve the ‘right care first time’ for every patient.

Phone First

Phone First is a telephone service available for members of the public who are unwell and considering travelling to an Emergency Department.

When you make a call, you will be medically assessed on the phone by a health professional and will then be given advice and, if required, directed to the most appropriate urgent or community service to meet your treatment or care needs.

This could include an appointment to attend an Emergency Department, an Urgent Care Centre, a Minor Injuries Unit or being redirected to a GP, Pharmacist or other service.  The service is currently available in the following Health and Social Care Trusts:

• Western HSC Trust
• Northern HSC Trust
• South Eastern HSC Trust
• Southern HSC Trust

For more information, see – Phone First FAQs – DOH/HSCNI Strategic Planning and Performance Group (SPPG) – formerly HSCB

Phone First does not replace 999.

For all emergencies that are life threatening, always call 999 immediately.

This can include: stroke, heart attack, loss of consciousness, breathing difficulties, severe bleeding or major trauma.

In addition, Phone First does not replace the advice or direction from your own GP practice or GP Out of Hours if they advise you to go directly to an Emergency Department.

Urgent Care Centres

Urgent Care Centres are one of the new ways that hospital and GP/primary care staff teams are working together to assess and treat patients, adults and children, who present with illnesses and injuries which require urgent attention but are not life threatening.

Rapid Access Assessment and Treatment Services

These services enable your GP to make direct appointments for you to be seen rapidly by the right specialist (Nurse, Consultant, Allied Health Professional) for assessments, tests, diagnosis; without having to go through an Emergency Department.

If required, patients will be provided ongoing support at hospital or community clinics.