How the NHS is preparing for winter across South Yorkshire and Bassetlaw

Tuesday 18th December 2018

Health and social care organisations across South Yorkshire and Bassetlaw have been working together to improve the delivery of care this winter.

Learning from pressures on services last year, hospitals in our area have introduced a range of initiatives to meet the challenges of winter demand through comprehensive planning and innovation.

From ‘streaming’ in emergency departments - taking a brief history and performing basic observations within 15 minutes of arrival to support triage to the most appropriate services - to putting in place specialist teams working on patient-centred discharge plans and transfers of care, hospitals are better prepared than ever before.

Earlier this year at Doncaster Royal Infirmary, Smart-ER was introduced to make the best use of technology by actively involving patients in their own treatment.

A number of computer terminals have been installed within the emergency department, with patients waiting encouraged to take a few minutes to enter their details. By completing this process, the patient is able to explain the reason for their visit, while also disclosing previous medical problems, all of which becomes part of their medical record. It’s already helping to improve communication in the emergency department, aids clinicians and uses the patient’s waiting time more productively, reducing overall waiting times.

Richard Parker, Chief Executive at Doncaster and Bassetlaw Teaching Hospitals, said: "As an organisation it’s important that we look to innovative where we can, making the best use of technology to improve care and treatment. Smart-ER is an example of how we are looking to improve our Emergency Department experience by using the time where a patient is waiting to have positive impact, providing information to help clinicians with the initial assessments and, ultimately, making a visit that little bit better."

Barnsley Hospital has introduced a Short Stay Unit (SSU) as part of the Acute Medical Unit (AMU). The purpose of the unit is to minimise the time patients have to stay in hospital, aiming to discharge people within 48 hours. There are now 16 dedicated SSU beds for patients who have been transferred from AMU. On SSU they receive specialist treatment from the urgent care therapy team, pharmacists, Breathe team, frailty and case management team.

To ease seasonal pressures, the hospital also has a new Patient Flow team made up of site matrons, an operational support manager and patient flow assistants.

The site matrons manage the Trust’s bed capacity and patient flow, assist in achieving key performance and quality standards, and support safe staffing levels.

A spokesperson for Barnsley Hospital said: “Winter in NHS terms can hit any time from September to January and we have been planning ahead for those pressures. We held a series of meetings with staff about what we want to do differently, looking at how we can vary capacity in times of pressure.

“We have in place dedicated management and leadership on urgent and emergency care and a new approach to how we ensure patients who attend our emergency department receive the most appropriate care by the most appropriate healthcare professional or service.”

“We are pleased that as we enter the winter period, we are already seeing the impacts of our work by maintaining a strong performance against the national four hour standard.”

Elsewhere in the local area, Rotherham Hospital has introduced Trusted Assessors in the emergency department to facilitate timely discharge with home becoming the default pathway where admission is unavoidable for a patient. A pilot earlier this year showed that 76% of patients returned home avoiding an unnecessary admission to hospital.

Orla Reddington, Clinical Lead for Inpatient Therapies at The Rotherham NHS Foundation Trust, said: “Our Trusted Assessors are playing an important role in helping to ensure our patients are getting the care they need when they need it, and can return home safely and in a timely manner following attendance at the emergency department.”

NHS England’s Joint Medical Director for Yorkshire and the Humber, Dr Paul Twomey adds: “The NHS has plans in place for the additional pressures that winter brings. We are building on our work from last year and will be monitoring the system across the region to help resolve issues.

“Patients should remember that it’s vital to get help early if you become unwell. You can now access your GP in the evening and weekends and local pharmacists can help with minor illnesses. If you need urgent health advice, call 111.”

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