A-Z site index | Search | Links | Contact DH | Help

TOP NEWS

A&E patients survey results

The first national A&E patient survey results were published by the Commission for Health Improvement (CHI) on 30 July. Each individual trust has a patient survey contact, who has the local results and who was responsible for forwarding them to CHI.

The national results include benchmark charts for each trust and PCT showing performance for all evaluative questions. As well as providing a national picture of patient experience in A&E, these results will inform local action planning and help to form a baseline for measuring progress.

This survey is part of the annual trust-based surveys carried out by CHI which began last year with in-patients. The A&E survey will take place every other year so the next one is due in 2005.

The full survey results are at www.nhssurveys.org

For further information e-mail clare.allcock@doh.gsi.gov.uk or telephone 020 7210 5161.

£40 million package for new NHS walk-in centres

Health minister John Hutton has announced a £40 million investment in new NHS walk-in centres. The money will be invested over the next three years and will mean faster and more convenient access to primary care for NHS patients.

NHS walk-in centres provide quick access to advice and treatment for minor ailments and injuries. No appointment is necessary. More than three million patients have attended the 42 existing sites since 2000. As they develop, the new centres will offer independent prescribing by nurses and access to GP services. This will mean that more patients will receive treatment and prescriptions at walk-in centres without having to go to their own practice.

John Hutton said: "We know that the public want and expect fast and convenient access to services in primary care. They want the flexibility to be able to choose to access services at times and locations which are convenient to their lifestyle.

"In recognition of the success of walk-in centres and of their potential to address specific local access issues, we are investing a further £40 million of capital incentive funding over the next three years. These extra resources will mean more patients will see the results of NHS reform in better and faster services."

For further information please e-mail MB-Access@doh.gsi.gov.uk

Locations of the existing NHS walk-in centres are at www.nhs.uk

Case study: Immediate response team project

A GP-led pilot project designed to respond to patients in immediate need is proving a major success.

Appropriate Care at Point of Need (ACAPON), based at a rural Norfolk surgery, brings together a paramedic, nurse practitioner and health care assistant, all under a dedicated GP’s supervision.

The aim is to provide more appropriate immediate and emergency care in the local community by allowing the lead GP to decide who is seen, where and when.

A key aspect of the project, based at the Birchwood practice in North Walsham, is the primary care paramedic, who brings expertise on emergency assessment, treatment and resuscitation.

Over an initial eight-month period, only 11 of the 305 patients who contacted the surgery before being seen by the paramedic needed hospital admission. Only five were transferred to A&E for minor injury assessment.

Unnecessary A&E admissions have reduced by half while 80 per cent of patients have been sent down much more appropriate treatment pathways. About £18,000 has also been saved through decreased ambulance use and unnecessary admissions.

Team leader Dr Paul Everden said: "My greatest frustration was the lack of time spent with patients. If you can get people through the system in a more appropriate way, you will help avoid the unnecessary transfer by ambulance to our already-overstretched hospitals.

"ACAPON has resulted in a faster response to need, a better use of health care resources, more selective use of ambulances and, most importantly, a clear message from patients that they are more satisfied with the care given."

It is hoped the scheme, which has attracted considerable interest from the Department of Health, can be extended to other practices.

For more information e-mail paul.everden@nhs.net

MORE NEWS

Emergency assessment toolkit

In conjunction with physicians working in acute medicine, the department's emergency care strategy team and the NHS Modernisation Agency's intensive support team have produced an emergency assessment unit toolkit to help acute trusts improve and streamline the care of emergency care patients.

Many trusts used funding from the A&E modernisation programme to establish emergency assessments units. The toolkit will enable trusts to build on this and provides a framework to help ensure that all possible steps are being taken to improve and streamline the care of patients presenting to emergency care. It also allows for local variation to build on local strengths and avoid unnecessary duplication of resources.

The principles outlined apply both to assessment units and clinical decision units. The toolkit stresses the importance of early senior involvement, access to diagnostics and the necessity for the flow of patients out of the unit to be maintained.

The toolkit can be found at www.doh.gov.uk/emergencycare/emergencyassmentchecklist.htm

Other toolkits to improve the delivery of emergency care are at www.doh.gov.uk/emergencycare/reportsguideance.htm

For more information and to provide feedback on the toolkit, e-mail Matthew Cooke, emergency medicine advisor to the Department of Health, at matthew.cooke@doh.gsi.gov.uk

New emergency care web pages launched

The department has updated and developed its emergency care web pages to reflect current work programmes and provide a useful area of reports, guidance and toolkits to help you in your work.

It is at www.doh.gov.uk/emergencycare/: please let us know what you think or e-mail your feedback to emergencycare@doh.gsi.gov.uk

Paramedic practitioner scheme for older people wins award

At the Health and Social Care Awards 2003. South Yorkshire Ambulance Service NHS Trust were awarded for their pioneering work with older people.

The Yorkshire trust scooped the Frontline Award for Emergency Care, for their Paramedic Practitioner, Older People’s Support Scheme.

The introduction of the scheme means that older people in Sheffield with minor injuries don't need to be taken to hospital. Around half of the patients who require care are now treated at home. The scheme is a joint initiative between South Yorkshire Ambulance Service NHS Trust, Sheffield City Council’s social services department and the Northern General Hospital’s accident and emergency department.

The judging panel viewed the initiative as: "An excellent innovative scheme which is having a major impact on avoiding unnecessary admission to hospital."

For more information about the scheme e-mail julie.perrin@sth.nhs.uk

Other emergency care initiatives were also highly commended. Whipps Cross University Hospital NHS Trust was praised for the implementation of fast track assessment, better joined up working with the on-site primary care centre, the opening of a new emergency medicine centre, and better discharge and home support planning. For more information contact david.cheesman@whippsx.nhs.uk

The Barnsley Children's diabetic ketoacidosis integrated care pathway was also praised for providing clear guidance on steps that need to be taken from the moment a child becomes ill. For more information contact loretta.davisreynolds@bdgh-tr.trent.nhs.uk

More information on the Health and Social Care Awards at www.doh.gov.uk/healthandsocialcareawards

Ambex 2003 Modernisation in Motion

Over 500 delegates attended Ambex 2003, the national ambulance exhibition on 27-29 June in Harrogate. The conference focused on the five Ps: patients, people, performance, policy and partnerships.

Professor Sir George Alberti, the NHS's national director for emergency access, was the keynote speaker.

Sir George outlined his vision of the role of a modern ambulance service stating that: "The role of the ambulance service is at the centre of the system and the only way we can make this happen is if we talk to each other."

He clearly set out the important role of emergency care networks that are led by emergency care leads locally, stating that: "The network should be empowered by the trust of all its partners, it should be properly funded and planning should cover the total system."

He acknowledged that the ambulance service was hampered by a lack of national standards, difficulties with training budgets and a lack of consistency with other professional education. However, he clearly thought that good leadership and determination are central to overcoming these obstacles.

Sir George also urged the ambulance service to look at developing five-year plans and adopting similar boundaries to strategic health authorities for simplicity of operations.

He said: " (Ambulance trusts) should also be prepared to publicise their successes and promote successful local programmes on a national basis to spearhead good practice."

Other presentations were made by John Wilderspin, the director of performance improvement at the NHS Modernisation Agency and Dr Tracey Cooper, associate director of education with the agency’s clinical governance support team.

For more information regarding the conference log onto www.the-asa.org

To send feedback to Sir George e-mail MB-GeorgeAlberti@doh.gov.uk

Change to the law on paramedics regulation

Since 9 July 2003 it is unlawful to practise as a paramedic unless you are registered with the Health Professions Council (HPC). Failure to register could lead to prosecution and a fine of £5000.

Guidance has been sent to employers to ask them to encourage any unregistered paramedic who they employ to apply for registration with the HPC straightaway. If employers continue to employ unregistered paramedics then their risk management strategy could be compromised.

If unregistered paramedics are employed as technicians then the target to have a paramedic on every frontline ambulance may not be met.

HPC registration fees are rising from £22 to £60 per year to reflect the stronger role the HPC will play in maintaining professional standards for paramedics and other professions, thus improving patient care.

The HPC is neither a professional body nor a trade union and is not there to provide members’ services. The Department of Health and the ASA are giving £180,000 over two years to establish the British Paramedic Association, which will provide a professional body for paramedics.

For more information log onto www.hpc-uk.org or e-mail chris.middleton@hpc-uk.org or telephone 020 7582 0866.

Head injuries guidance

Guidelines from the National Institute for Clinical Excellence (NICE) will increase the importance of nurses’ roles in assessing and treating head injuries.

Triage nurses will be required to immediately assess patients presenting with impaired consciousness before deciding whether the patient should be admitted.

The guidance also details procedures for NHS Direct nurses on carrying out prompt assessments, based on both a caller’s current symptoms and any history of head injury. Nurses working in minor injury clinics will also assess a patient’s suitability for referral to A&E.

Gabby Lomas, a senior A&E sister at Hope Hospital in Salford who helped develop the guidelines, said: "The most significant aspect is that CT scans will be carried out earlier. The guidance will also help deliver a consistent level of care across the country as it can vary at the moment. For nursing, there are specific benefits, such as giving those working in NHS Direct their own guidance on assessing whether someone needs to be referred to hospital. At Hope Hospital, we see about 65,000 patients each year and we are very fortunate that a lot of the procedures outlined by NICE, such as rapid assessment, are already in place here."

Ms Lomas said the guidelines raised obvious training issues, with nurses requiring teaching in various new procedures. "Overall, ensuring the guidelines are implemented fully will mean a lot of multi-disciplinary working with other teams such as radiotherapy departments," she added.

The guidelines are at www.nice.org.uk

Emergency services collaborative update

Half of England’s 24-hour A&E sites now are reporting results in the Emergency Services Collaborative (ESC) programme of improving emergency care experiences for patients and carers.

Waves 2 and 3 have joined Wave 1, fortifying the ESC’s programme to enable all 24-hour A&E sites to meet The NHS Plan December 2004 target of seeing, treating, admitting or discharging all patients within four hours of arrival at A&E.

More than 85 per cent of Wave 2 and 3 patients on average were seen, treated, admitted or discharged within four hours in May.

Waves 2 and 3, which in April attended their first workshops and began reporting results, are in line with expectations of early-stage performance.

For Wave 1, more than 90 per cent of patients on average were seen, treated, admitted or discharged within four hours in May. Wave 1 sites are exhibiting sustainable change, with overall performance of the wave exceeding the 90 per cent four-hour target since late March, or Week 13, as demonstrated in Figure 1:

Self-assessment is a key barometer of the success of the programme and early indications are promising.

Project teams in Wave 1 posted a mean self-assessment score of 2.9 in the sixth month of the programme, in line with the 2.9 posted by the Cancer Services Collaborative and better than the 2.3 for coronary heart disease programme at similar stages.

For further information on the collaborative, its events and the national report, contact Kerrin Howard at 020 7061 6780 or e-mail Kerrin.Howard@doh.gsi.gov.uk or visit our web site at www.modern.nhs.uk/emergency

Recent additions to the electronic library and toolkit

A summary of recent additions to the National Electronic Library for Health's emergency care specialist library is at www.nelh-ec.warwick.ac.uk/ and recent additions to the emergency care toolkit are available at www.nelh-ec.warwick.ac.uk/ECL_Toolkit/index.html

DIARY

Reducing cancelled operations

A one-day conference will be held on 12 November for all levels of staff who have an interest in theatres and pre-operative assessment.

This event will introduce delegates to fresh thinking to optimise capacity for day and inpatient surgery. Delegates will explore the benefits of using teams from abroad, effective use of day and inpatient surgery, increasing bed capacity through pre-operative assessment and the theory of constraints.

Conference fee £95. Call Kelly Giles on 0116 2225146 or e-mail kelly.giles@npat.nhs.uk

This conference is organised by the NHS Modernisation Agency’s operating theatre and pre-operative assessment programme at www.modern.nhs.uk/theatreprogramme

Top

copyright: © | Last Modified :