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July 22nd 2016

Gavin Boyle
Scorchio! That’s probably the best way to describe the first part of this week with the hot weather presenting particular challenges for our people and the hospital in general.  I mentioned last week about the increased demand, particularly to treat patients presenting for urgent and emergency care, and there has been no let-up this week.  The hot weather seems to have added to it all with patients coming in with the effects of dehydration and perhaps pollen triggering existing respiratory conditions.  It’s a good opportunity to remind everyone about taking the right precautions during hot weather and particularly staying hydrated.

I’d like to take this opportunity to thank all our teams who have worked so hard over the last week to manage this high level of demand and keep our patients safe and well cared for;  not only our clinical teams but also the many who work behind the scenes to keep the wheels turning. 

My blog this week has quite an urgent care flavour to it and this subject is very much at the forefront of my thinking at the moment. 

On Tuesday I had a terrific ‘urgent care pathway’ walkabout with our Chief Operating Officer, Sharon.  As you might expect our first call was the ED itself where we met up with Sister Ann-Marie Hancock and Dr Peter Cull one of our A&E Consultants.  They described some of the particular challenges they were facing at present and the steps they take in order to keep patients safe.  Sometimes when large numbers of patients require admission to the hospital, the beds are not always immediately available, and this can mean the patients wait longer than we would like.  Improving flow through the whole of the hospital is clearly a priority – more of that in a minute – but I was really impressed when Ann-Marie described all of the steps they take to make sure that if patients are waiting for admission in ED  they are properly cared for and kept safe. 

My next call was to our Children’s ED which has also been extremely busy of late.  I met up with CED Consultant Graham Johnson, who also works on the adult side too.  I think we are extremely lucky as a community to have a dedicated Children’s ED and I’m always impressed by the quality of care that some of our youngest patients receive there.  It was then on to our Medical Assessment Unit. This is where patients who have either attended ED or referred in by their GP have their initial assessment by the acute medical team. This senior review right at the front door makes sure that our acute patients are set on the right track from the start and are directed to the right specialist team from this initial phase.  Sisters Caroline and Dawn were on hand to give me an update and describe how they were working hard to meet current demand.  Caroline has only just returned from maternity leave and must have felt she’d jumped back in at the deep end! I was impressed at the good humour of the team and their upbeat attitude.

Meeting the challenge of rising emergency demand is not just the work of the hospital. On Thursday morning I attended the Urgent Care Board, which was chaired by one of our local GPs. It brings together all the different services health and social care services to find ways of better meeting this rising demand.  Working together as a system is the only way we can do this effectively, and regular readers of the blog will know how important I believe this type of partnership working is.  We had a fabulous presentation from Tan and Reza, two of our Consultant Acute Physicians in the Medical Assessment Unit. They had a great idea about how they could deliver a different type of service to meet the needs of patients attending with serious infections.  The new model would make sure patients got the treatment they needed but didn’t have to stay overnight in hospital. This would clearly be better for patients – after all who wants to be in hospital if it can be avoided? – but also to help to release beds for other patients. There was a lot of support for this idea around the table, and a real commitment to try out this new way of working ASAP.

I also caught up with Roger Stanworth, one of our Diabetologists, this week. He is is leading a piece of work with two of our wards to try to minimise delays for patients in hospital. Remember the SAFER bundle I mentioned last week?  This involves making sure any unnecessary delays are sorted out, and that  arrangements for out of hospital support are made promptly, so patients can get back home as soon as possible.  Thanks to Brigitte, one of our Medical Bed Managers, who took me on her rounds to show me some of the issues first-hand.  Safely reducing the length of time patients stay in hospital is an important quality improvement, particularly for frail elderly people for whom being in hospital can present risks. They could fall in an unfamiliar environment and often the longer an elderly person remains in hospital the less able they might feel to return home. I was delighted that Roger was leading this work with those ward teams and the commitment they were showing to reducing risk for our patients and providing a better service.

I also caught up with Chris Whale and Will Elston, two of our Clinical Directors, who are planning to try out how we can increase discharges on a Sunday and speed up assessment on Mondays – two of our busiest days.  Great Stuff.

There will be a break from the blog for a couple of weeks – I’m off on leave – but I have asked Cathy Winfield our Chief Nurse & Director of Patient Experience to hold the fort while I’m away.  I’m sure many of the challenges I have described above will be waiting for me on my return but I’m in huge admiration for everybody who works so hard day in day out to deliver our services and also for those who are stepping forward to find the answers to some of the challenges we face.

All the best, 

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Gavin 

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