The 2017/18 NHS winter crisis has been one of the worst on record, with daily headlines emerging of the unprecedented pressures being faced by NHS Trusts seeking to meet patient demand. NHS figures have revealed that over 100,000 patients have had to wait in an ambulance for more than half an hour this winter and that A&E waiting times have now reached the worst levels on record.
For all Trusts and CCGs the long term solution to tackling winter demand and averting these struggles in the future lies in a fundamental rethink of how care is delivered and how all services can work towards increased productivity and efficiency to improve provision.
A Redesign of Health and Social Care
Across the NHS the move towards health and social care integration, community services and self-care will be critical in alleviating the pressure on A&E departments.
150 Urgent treatment centres have been rolled out already which will contribute to local 4 hour waiting targets. These GP-led services are already working to offer support for some of the most common reasons for A&E attendances.
The NHS’ Vanguards programme is also trialling a number of schemes seeking to implement new models of care which support successful health and social care integration. The development of community based schemes and the use of technology are becoming increasingly vital in preventing delayed discharges and unnecessary hospital admissions.
Improving Ambulance Service Provision
The effective deployment of ambulances is vital to any urgent and emergency care system and the roll out of the NHS’ new Ambulance Response Programme (ARP) with new response times will be key to improving performance. The NHS predicts this system will result in faster treatment for stroke and heart attack patients and will lead to a more immediate response for 750,000 callers annually. The core ambition is to improve operational efficiency, which means that Trusts will also need to address wider questions of staff deployment, handover procedures and the relationship of ambulance services with community providers.
Of course, there is still major work to be done in ensuring that A&E departments themselves are being run as efficiently as possible and a vital component of this is improving patient flow.
A&E departments must constantly assess how ambulance handovers are conducted, the role of clinicians in managing patient demand, how patients are screened and streamed on entry and how staff can be most effectively deployed if hospitals are to deliver the best outcomes for A&E patients next winter.
To explore solutions to addressing patient demand and supporting improved outcomes in A&E departments, join NHS England, The Care Quality Commission and The Royal College of Emergency Medicine at the Annual Urgent and Emergency Care Conference 2018 taking place on Tuesday 15th May 2018 in Central London.
Written by Callum Clark, The Urgent and Emergency Care Conference 2018