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Emergency Care Bulletin
Housekeepers in A&E helping to bring about improvements Housekeepers, now in place in some A&E departments, are making a critical contribution to improving the patient experience. They are also helping to free up nurses’ time – an estimated 15 per cent of which is spent on non-clinical tasks. A joint project by NHS Estates and the NHS Modernisation Agency suggests the introduction of ward housekeepers will free nurses up to concentrate on more clinical duties. The Redesigning Emergency Care project has produced a whole-systems model for delivery of effective care in A&E. The project involved creating mock-ups of A&E departments. Clinicians, facilities staff, nurses and patient representatives visited the mock-ups and commented on them. Support services were also assessed by mapping the movements of staff and patients. Patients were accompanied during their time in the department to find out who waits where, why and for how long. Computer modelling showed that a high proportion of nurses’ time is spent carrying out support services, in particular, in minor treatment rooms. Ward housekeepers would carry out some of these tasks. They can make sure that wards are clean, comfortable and friendly, that supplies don’t run out and that patients have access to help, reassurance, information and food and drink if appropriate. They also make sure that equipment is clean, working and ready to use. Housekeepers already in post in A&E say one of their favourite parts of the job is speaking to and reassuring patients. The relationships they build with doctors mean the patients are kept better informed. Where housekeepers have been introduced, patients tell us they are receiving a more personalised service and there are fewer complaints. For more information contact Neil Thompson at NHS Estates on 0113 254 7209 or visit www.nhsestates.gov.uk/patient_environment
This month the national director for emergency care access Sir George Alberti talks about the next steps towards lasting improvements "So far the major focus has been, not surprisingly, on emergency departments to meet the A&E milestone. The next target for the NHS is clear – for all patients to be in and out of A&E within four hours by December 2004. To meet the next target, and to make lasting improvements in both patient care and patient experience, the whole system will need to be improved. Three areas are under scrutiny: the community, where better integration of services could avoid the need for people to attend hospital emergency departments; mental health, where there has been too little attention paid to emergency care; and the hospital beyond the emergency department, where both bed management and professional working patterns need to be fine tuned. We have just established a working group on mental health emergencies, which will report by the autumn. "It would be very helpful if anyone who feels they have good systems in place for any of these areas could e-mail me on george.alberti@doh.gsi.gov.uk or george.alberti@ncl.ac.uk." A&E staff praise Health secretary Alan Milburn has written to all heads of A&E departments to thank staff for the clear and sustainable progress that has been made in reducing waiting times for patients. Staff who wish to see the full letter can ask their head of A&E for a copy. A National Burn Bed Bureau (NBBB) was established in April for the British Isles, to help improve access to services for people with burn injuries. The bureau is being run and managed by the West Midlands Ambulance NHS Trust with initial funding from the Department of Health. Should an A&E department not be able to admit a patient to their nearest service they will be able to contact the NBBB 24 hours a day, seven days a week, to establish where the nearest available bed is located. Contact the service by telephone 01384 215576 or fax 01384 215580. Further information is available from Mark Curran or Sue Williams at the West Midlands Ambulance Service. Telephone 01384 215712/215883 or e-mail mark.curran@wmas.nhs.uk or sue.williams@wmas.nhs.uk What To Do If You’re Worried A Child Is Being Abused has been published by the Department of Health. It has been developed to assist practitioners to safeguard and promote the welfare of children. It also contains an appendix covering the legal issues affecting exchange of information. It is targeted at all those who have contact with children and their families in their work. Chief executives have been asked to pass copies on to staff.
Further copies of the booklet are available at www.doh.gov.uk/safeguardingchildren/index.htm or obtained in hard copy by calling 08701 555455 Further information is available from the Victoria Climbié Inquiry response team on 0207 972 4977. Nurses’ extended formulary for independent prescribing A three-month consultation on proposals to extend the Nurse Prescribers' Extended Formulary (NPEF) is underway. This will extend the range of medicines that nurses can prescribe independently. It is important that staff working in emergency care comment on the list and are involved in the consultation process. This will help to identify any medications currently missing from the list that they consider to be essential for meeting patient needs in a timely way. The consultation ends on 23 July. For more information visit the Medicines and Healthcare Products Regulatory Agency website at www.mhra.gov.uk Ambulance service developments The Department of Health and NHS Modernisation Agency have been working together to develop a series of initiatives to integrate the work of ambulance services. This includes the agency’s ambulance group, the ambulance Category A taskforce, working with Patient Transport Services, central policy support and emergency care networks. Details of the actions being taken in these areas were included in a recent letter sent to ambulance services. Please see link below. For more information contact Daniel Scheffer on 020 7210 5126 or e-mail daniel.scheffe@doh.gsi.gov.uk
Emergency Services Collaborative update A&E sites working with the collaborative continue to exhibit signs of sustainable change, as wave 1 sites have complied with The NHS Plan four-hour milestone for the past six weeks. During May, wave 2 and 3 completed the first stage of the programme - testing small cycles of change within the seven-day plan-do-study-act (PDSA) challenge. The sites will report back to the wave leads, who analyse the successes and failures with the relevant programme managers. Wave 4 had its first programme manager meeting in preparation for the first stage of the programme. Wave 5 and 6 held their Information Days, at which site representatives are educated on the collaborative’s methodology, goals and event timeline. The Information Days are pre-cursors to the actual launch of the new waves. Wave 5 will launch on 1 July and wave 6 on 22 July. For further information on the collaborative, its events and the national report, contact Kerrin Howard on 020 7972 1129 or e-mail Kerrin.Howard@doh.gsi.gov.uk or visit www.modern.nhs.uk/emergency Information on other NHS Modernisation Agency improvement programmes is also available at www.modern.nhs.uk 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 available 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
Emergency care discussion forum Log onto the web-based discussion forum for people working in emergency care and associated networks at www.info.doh.gov.uk/doh/emergencycareforum.nsf The password has been featured in previous editions of the bulletin or is available from your Emergency Care Lead.
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