Lancaster hospital’s 15 minute A&E assessment target

The Emergency Department at the RLI faces continued pressure.
The Emergency Department at the RLI faces continued pressure.

Patients will be assessed within 15 minutes of arrival at Lancaster’s Emergency Department as part of a new pilot project.

The scheme has been introduced as Morecambe Bay’s health trust fails to hit both the A&E four hour waiting time target, and the planned ops and care 18 week target.

Starting this month, GPs based at the Royal Lancaster Infirmary (RLI) will begin working in new ways to ensure people receive the right type of care for their condition.

People attending the Emergency Department will be assessed by a triage nurse – who is already in place – within 15 minutes of arrival.

The initial assessment will determine whether they need emergency treatment or are suitable to be seen by a primary care professional.

University Hospitals of Morecambe Bay NHS Trust (UHMBT) says this will help free up emergency department professionals to use their expertise to focus on major/life threatening health issues.

Currently, the trust is failing to meet the NHS’ four hour A&E waiting target - where a patient is treated or admitted within four hours.

The target is 95 per cent, and the trust managed 89.4 per cent in September 2017.

It last hit the target in August 2015.

For planned operations and care, the national target is for 92 per cent of patients to be dealt with within 18 weeks.

The trust managed 88.3 per cent in August 2017, against a national average of 89.4 per cent.

The trust last hit the target in December 2015.

However it is performing well in terms of cancer care, where the national target is for 85 per cent of patients to begin treatment within 62 days of urgent GP referral.

The trust performed at 85.9 per cent against a national average of 82.6 per cent.

The BBC’s NHS target checker ranked UHMBT 91 out of 131 trusts nationwide.

As part of the new 15 minute pilot project, GPs will be sourced primarily from local GP practices and will be based in the minor injuries department each day.

With support from the co-located out of hours primary care service, this service will be provided from 8am to 8pm, Monday to Sunday.

Foluke Ajayi, chief operating officer at UHMBT said: “We welcome this new way of working at the Trust.

“We have faced increasing ED pressures over the past few years and as we come into winter, ED pressures will only heighten due to cold weather, respiratory infections as well as the numbers of people suffering falls.

“The new way of working will ensure patients receive the right type of care for their condition and prioritise those most at need of emergency care.

“The whole of our workforce is focused on improving the patient experience this winter.”

Jackie Daniel, chief executive, UHMBT, said: “This is a very positive initiative which uses existing resources a little differently.

“We are continuing to work very closely with our health and care partners in the Bay to improve care for our patients.

“Like the rest of the NHS, we are anticipating a busy and challenging winter and the safety of our patients remains our priority.”

Dr Alex Gaw, Clinical chairman for Morecambe Bay Clinical Commissioning Group (CCG), said: “This innovative way of working allows us to utilise existing resources to help ease increasing pressures within the Emergency Department.”

Foluke Ajayi added: “Our hospitals, along with many others across the country, continue to be under significant pressure.

“Unfortunately, this can sometimes mean patients wait longer than usual in our Emergency Departments (EDs) to be treated or to be admitted to a bed.

“We know that this is not an ideal situation for patients or our staff so we are working hard with our partners across health and social care to do all we can to address the pressures we are facing.

“It is important to note that improving our waiting times in our EDs is not just about what is happening in the ED, but about patient flow throughout our hospitals and community services.”

The trust said it had launched a number of other measures to help relieve pressure on its emergency department.

These include expanding the size of Hospital Home Care Team, where Clinical Support Workers support patients in their homes until their care package is available, wards now have a target of discharges before noon, introducing schemes to avoid unnecessary admissions to hospital and working with local care homes to increase capacity.