Skip to main content

Development Phase

This was aimed at developing an understanding of the ‘current state’ and in parallel, gathering ideas, information and intelligence to identify ‘what good looks like’. In simple terms, this phase was a process of widespread engagement and information gathering to answer the questions, where are we now and what does good look like for Emergency Departments across Wales.

The Programme Team worked with stakeholders from across organisations to gather information, synthesising that knowledge into rich descriptions of different aspects of the care provided within an Emergency Department and facilitating continuous feedback and refinement of those descriptions.

This process of gathering information was undertaken in a number of ways; through surveys, interviews, workshops and traditional electronic data extracts and analysis. The information was collated and curated using the collaborative commissioning methodology, known as CAREMORE®.

During Phase One, developments focussed on collecting baseline information, to generate draft schedules for Activity, Resources and the Review of Performance. This work helped to inform the production of Care Standards, based on the available evidence and feedback from clinical teams. These Care Standards were then mapped to a high level Model of Care.

Each step in the Model of Care contains a Quality Statement and four outline descriptions of the relevant Care Standards under that step. Each Care Standard is intended to encompass a number of activities, resources and operational arrangements. The detailed scope and description will be developed by the participating teams in Phase Two, which is initiated by signing off the high level Model and Care Standards.


CAREMORE® is a registered trade mark belonging to Cwm Taf Morgannwg University Health Board (UK2630477) and is an award winning method of collaborative commissioning developed by the National Collaborative Commissioning Unit and its partners, based within NHS Wales.

At the heart of the CAREMORE® method is a commitment to real collaboration and coproduction with the people who have a stake in the service area. As such the methods that are used in the production of a shared framework involve widespread engagement, data collection, distributed sense making and the design and delivery of a series of participative development sessions with stakeholders. These workshops create the space for participants to share learning; test, challenge and evaluate the products; and update, amend and literally compose the detailed specifications within what becomes a published Quality and Delivery Framework. The whole process is guided and supported by an expert Production Team.

Element Description
Care standards An evidenced set of care standards to ensure that the right expectations are defined for quality and safety
Activities An accurate description of the activities to ensure that the right capacity is available to meet the right demand
Resource Envelope A comprehensive description of the assets which may be utilised and affected with the ambition of making the best use of all existing resources
Model of care A common high level model of care to ensure that people can access the right staff, at the right place, at the right time
Operational The establishment of robust local mechanisms to ensure effective delivery with the right interaction between the public, professionals and organisations
Review of performance An agreed system of performance measurement to ensure the right monitoring and management to deliver continuous improvement
Evaluation An agreed set of methods and criteria for judging the achievement of the right outcomes, from the right experience, at the right cost