Fiona Dalton, CEO

Chief executive's blog - 18 November 2014

In my personal blog, I will keep you up to date on what is happening at the Trust, sharing what I think we are doing well and what we can improve.

Fiona Dalton, chief executive

I'm sure that every one of us is aware of issues within the emergency department, and the challenge of coping with constant arrivals of new emergency patients, whilst keeping patients moving promptly to beds and also treating quickly those that don't need to be admitted.

This challenge is reflected in the national four hour emergency access target, which is seen as a temperature gauge for the emergency care system. The NHS nationally is struggling with this target, but it is a particular issue for us, and currently we're not giving our patients the care that we would like to.

Some people may have seen the recent national announcement of additional money to help the NHS cope this winter - and it's been agreed that a substantial amount of this money will come to UHS.

Of course, it is challenging to work out how to spend this money in the best way - we want to make a difference very quickly and many of the things that we would like to 'buy' (like for instance extra experienced doctors and nurses) are not immediately available.

But I believe that we have a good list of projects that will make a real difference to how long emergency patients have to wait for either treatment or a bed.

For instance, many teams have talked to me about how outdated computer hardware slows their work down, and therefore also delays patients' progress through the hospital. So we have been able to allocate some of this new money to buying new computers for clinical areas.

In addition to going out for additional temporary clinical staff (doctors and nurses), who are of course difficult to find, we will employ more support staff, like porters, because we all know how important they are to avoid patients having to wait.

And finally, we have also reserved some money for new ideas from everyone who works within the hospital. So if you have an idea which will make a difference to patients coming through the emergency department, and if this idea could be tested relatively quickly, then we want to hear from you! A system will be announced soon, or if you just email me I can forward your idea on to the right place.

This additional money has come to UHS because it's felt that at this late stage, we are the organisation that can best use it to make a difference. We're not in control of the whole system, and we have to work in partnership with other health and social care providers, but we do have significant control and influence.

Delivering the four hour target will require us all to do what we can and I know that I can rely on everyone here to do all that they can to help, and to allow us to demonstrate that with extra money we can work as a team to deliver improvements.

And a personal thank you in advance from me to you all.

Fiona Dalton


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Page comments

Thank you for your informative blog.I have just read the comment(18/11/2014) suggesting setting up a primary care type facility adjacent to ED, allowing a preliminary triage of patients. This sounds a sensible solution to me, speaking as an ordinary member of the public. As I understand it, Emergency services are presently inundated with a wide-range of patients, many of whom may be misinterpreting the role of 'emergency' care in that their medical needs could be met by non-emergency care. Whatever the cause of the rise in patient numbers presenting at A&E departments, it is necessary for the hospitals to find ways of reducing these numbers.
Another issue seems to be the arrival of 'repeat' cases, such as those addicted to alcohol and/or other substances. And yet another category is made up of elderly patients.
Considering the range of patients and their numbers, it would seem that as many as possible forms of preliminary triage would be hugely valuable in enabling patients to be directed to the appropriate facilities quickly. What the hospital really needs is a Substance Abuse Unit; a specialist Elderly Care Unit and a Primary Care Unit all adjacent to ED. Your new computer system would allow the hospital to have a reception area which is in fact a data base enabling you to match patients' details quickly to their medical history and facilitate the necessary triage of patients to relevant care areas.
This will of course be expensive, but some instant changes could occur through re-organisation of existing facilities, and the acquisition of new computers which you mention in your blog. As a University Hospital, you could have access to assistance from relevant technical departments of the University with building up-to-date data bases and computer programs designed for the specific needs of UHS.
Emergency departments could also inform all patients, by signboards prominently displayed, that A&E is for 'emergency' cases only. The national and local press could be co-opted to inform the general public of their responsibilities.
Sorry, I probably could continue but I want to maintain the focus on emergency care.I do think it is appropriate to ask the public to do more as, in general, the NHS is widely loved and respected. Get the public on board!
Anonymous (24/11/2014 10:34:00)
Hi Fiona, Great blog as always. I'm not sure our commissioners would buy into my idea, but often wondered about having a primary care type facility immediately adjacent to ED. That way those triaged to need likely admission are streamlined into ED, and those not can still get urgent treatment, with easy escalation back into the hospital if required. I guess rather depends on how much money there is left in the pot! Just a thought....
Anonymous (18/11/2014 21:23:10)