According to a recent report by The Guardian trusts are taking emergency measures in response to a surge in A&E patients. What is happening across the UK and what role can patient flow play in combatting an NHS winter crisis?
To cope with the challenges this winter brings trusts appear to have taken a two-pronged approach: expansion and partnership. The expanded provision includes extra beds, cubicles and temporary wards and extends beyond hospital walls with the hiring of nursing home beds, more home care, hospital sharing, increasing GP and practice nurse referrals and walk-in centre provision.
Much of the expanded provision includes effective partnership working and joined-up services to pool resources and divert patients.
What’s happening in the NHS now?
Southend Hospital in Essex diverts around 50 patients with minor ailments to a GP or practice nurse.
Using an app developed with the regional NHS ambulance service, nine tech savvy hospitals in the north-east will divert non-urgent patients to each other.
Also in the north-west, a collaboration between ambulance crews and hospital trusts aims to cut those taken to hospital following a 999 call by 40% by treating patients at the scene, or arranging social care.
In partnership with the county’s community healthcare trust, Maidstone and Tunbridge Wells trust in Kent has launched a “hospital at home” service.
Ipswich and Colchester hospitals trust has hired 70 nursing home beds for patients and Sherwood Forest trust bought 20 care home places.
NHS England’s medical director for acute care, Professor Keith Willett, praised trusts for implementing “innovative and practical measures”.
Can we avoid another NHS winter crisis?
It’s almost certain that the NHS will come under strain this winter. Hopefully, a full-blown NHS winter crisis can be avoided but improving visibility of patient flow is key to maximising the use of the NHS’s resources, whichever initiatives hospitals choose to pursue. Paper-based flow management limits change and reduces visibility of the system as a whole – from GPs to hospitals to social care.
Andrew Foster, chief executive of Wrightington, Wigan and Leigh trust in Lancashire (WWL) said: “The good news is that we don’t have the flu we had last winter and have put a lot of things in place for this winter. The bad news is that 4% more people than last year are arriving at A&E, the number we’re admitting is 12% up on last year and the people coming in are sicker.”
The chief executive of NHS Providers, Chris Hopson said: “Trusts have once again gone to great lengths to prepare ahead of what is likely to be an extremely challenging winter. Despite these efforts, no one should be in any doubt that the next few months will be extremely tough.”
The missing piece?
For all these measures to be as efficient as possible a vital component is a system to manage patient flow. A&E departments must continuously assess how hospitals are able to anticipate and respond to patients, the role of clinicians in managing patient demand, how patients are screened and processed on entry and how staff can be effectively deployed if hospitals are to deliver the best outcomes this winter and beyond.
Starting the journey to digital patient flow must happen now
“In our experience, you can’t start soon enough. It shouldn’t be seen as a ‘big bang’ project. In fact, a good patient flow system should augment rather than replace. It’s about putting information where it’s useful,” said Susan Say, Managing Director of ExtraMed.
ExtraMed Patient Flow provides a fast, intuitive solution that will help to ease the pressure from the front door to the back door. The more visibility you have of patients coming into the system, the more proactive your teams can be. Frontline staff can monitor real-time situations, such as bed availability, without physically having to do the rounds, and enables senior staff to identify bottlenecks and support the flow of patients safely and efficiently through the hospital, and, with short and longer-term data collection, supports enhanced strategic planning.
Patient Flow can be live – with all systems ready and staff trained – in just 12 weeks. So, while you might not get fully digitised through this winter period, we can start the process and deliver a system that will make a difference straight away – like Derby Hospitals did (Case Study).