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'One year on' for new model of emergency care

Monday, June 13, 2016

Northumbria Healthcare NHS Foundation Trust has today published a ‘One Year On’ update and video detailing the significant improvements in patient care, as well as the initial teething challenges, of its new model of emergency care introduced last summer across Northumberland and North Tyneside.

This week sees the first year anniversary since the opening of the Northumbria Specialist Emergency Care Hospital in Cramlington and healthcare leaders have today praised NHS staff for their tremendous efforts during a year of such huge transformational change and an exceptionally busy time for services.  Key findings from the update show:

·         A 15% overall increase in urgent and emergency care activity, with over 150,000 attendances across both The Northumbria hospital and at 24/7 Urgent Care Centres in Hexham, North Tyneside and Wansbeck hospitals

·         Northumbria Healthcare being one of only a handful of trusts nationally to meet the four hour standard for patients to be seen within four hours during the whole of 2015/16

·         A 14% reduction in emergency admissions to hospital, with almost 7,500 less people being admitted, resulting in a £6 million saving for the local health economy

·         Senior clinical decision making from emergency medicine consultants on site 24/7 and almost 80,000 radiology examinations performed, resulting in much quicker diagnosis and treatment for seriously ill or injured patients

·         Improvements in clinical outcomes, for example in cardiology where very early indications show the number of people now surviving heart attacks has dramatically increased since the centralisation of specialist expertise in June

·         Consultants in a range of specialties, including consultant cardiologists, now working seven days a week and doing twice daily ward rounds on a Saturday and Sunday, just as they do on every other day of the week

·         9 out of 10 patients using the emergency department at The Northumbria rated their care as good, very good or excellent and 97% of inpatients at The Northumbria would recommend their care to friends and family.

The transformation of urgent and emergency care has not, however, been without its challenges.  The Northumbria Specialist Emergency Care Hospital is now the largest receiving emergency department in the North East and the centralisation of emergency care has impacted on the performance of ambulance handover times with around 7 per cent of all ambulance arrivals at The Northumbria waiting over 30 minutes to handover patients.

Northumbria has been working closely with the ambulance service and other partners to actively address this problem and make sure patients have a smooth transition into the emergency department, especially during times of peak demand.  This figure is now showing signs of improvement and plans are in place to improve the physical space for ambulance arrivals in preparation for next winter.  

A widespread public awareness campaign ran throughout 2015 to advise the public on how to access services depending on the nature of their problem, including signposting to primary care.  This was largely successful with around half (47%) of all attendances taking place at 24 hour Urgent Care Centres in Hexham, North Tyneside and Wansbeck. 

Of the 53% of attendances at The Northumbria, the number of walk-in patients has been higher than anticipated and messages continue to be embedded with members of the public, and with the health and care system, to ensure people understand the new model and are signposted to the right service. 

Mr David Evans, chief executive of Northumbria Healthcare NHS Foundation Trust said: “There is no doubt that our new model of emergency care is already having a very positive impact on patient care, clinical outcomes and experience.  All early indications and measures show it is delivering exactly what we set out to achieve for emergency patients by centralising our specialist expertise on one site.

“Delivering these successes, as well as overcoming the challenges experienced during this first year, would not have been possible without the efforts of staff in all areas – not only at Northumbria but amongst the wider local NHS.

“Delivering such large-scale change is extremely difficult and I would like to thank all partners, in particular the North East Ambulance Service, for their support in helping us to work through some of the challenges experienced and, of course, those patients who have experienced any delays when arriving at The Northumbria this winter.  Despite this, we should not underestimate the scale of what we have collectively achieved and the very positive benefits we are already seeing for patient care.”

Dr Jeremy Rushmer, medical director at Northumbria Healthcare NHS Foundation Trust said:  “Our teams have taken the challenges of the past year in their stride and I am extremely proud to see the fruits of over ten years of planning and discussion now improving the service we offer to emergency patients. 

“Such transformational change in the NHS is not an easy thing to deliver but the benefits we are seeing for patients are already very clear and all staff should be rightly very proud of what has been achieved since The Northumbria opened.  As we look to the year ahead, we are now also starting to see some of the benefits of this new model on our general hospital sites where we have developments underway to enhance the care environments for those coming in for planned treatment.”

Dr Colin Doig is a consultant cardiologist who works in The Northumbria looking after emergency heart patients.  He said: “The really big difference of the new model is the speed at which everything happens and the quick diagnostics which mean we are getting patients home much sooner than ever before.

“For patients being admitted with heart failure, the speed of diagnosis and ready availability of a cardiologist opinion, means their average stay in hospital is now one or two days – previously they may have been in hospital up to six days if they had been admitted on a weekend.  The emergency service we offer now is exactly the same on a Friday, Saturday, and Sunday as it is on a weekend.  In my 25-year career as a consultant cardiologist, nothing comes close to this level of quality improvement and it’s a privilege to be part of it.”

Doreen Wilkinson is one patient who is benefitting from specialist heart care available at The Northumbria hospital.  Doreen, 66, experienced sudden chest pain and shortness of breath at home in the early hours of Sunday 5 June. She called 111 and they sent an ambulance to her home in North Shields which took her to The Northumbria for emergency treatment.

When in the emergency department, where emergency medicine consultants are on site 24/7, Doreen was quickly assessed and underwent diagnostic tests which showed she was actually having a heart attack.

She was moved to the specialist cardiology ward where she was seen by one of the team of cardiology consultants who work every day of the week – including doing ward rounds on Saturdays and Sundays – to see emergency heart patients.  Doreen immediately received blood-thinning medication to help reduce the blockage in the arteries in her heart, while she awaited transfer to the Freeman Hospital.

Doreen said: “The doctors have said this has been a warning for me and could have been much worse.  I really couldn’t fault any of the staff at all, they have been brilliant. Nothing has been too much bother for them and they go the extra mile.”

Doreen was cared for in one of the single en-suite rooms on the ward and has been very impressed with all aspects of her experience.

“Alongside having access to specialists throughout my stay, what I’ve really liked about this hospital is that it’s not a long ward,” she said.

“The nurses can stand in the middle and look into every patient’s room and you never feel on your own.”

Doreen, a mother of two, also praised the food and the fact that diagnostics is based adjacent to the emergency department, meaning patients do not need to go to another part of the hospital for tests.

Only last month, Northumbria Healthcare NHS Foundation Trust was rated ‘outstanding’ by the Care Quality Commission with the Northumbria Specialist Emergency Care Hospital and general hospitals in Hexham, North Tyneside and Wansbeck all receiving an outstanding rating.