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How your A&E experience will change as under-pressure hospitals miss waiting time targets

PUBLISHED: 11:30 24 February 2019 | UPDATED: 12:15 24 February 2019

An artist's impression of what the revamped Colchester Hospital will look like. Picture: East Suffolk and North Essex NHS Foundation Trust

An artist's impression of what the revamped Colchester Hospital will look like. Picture: East Suffolk and North Essex NHS Foundation Trust

Archant

The way A&E departments in Suffolk and north Essex treat patients is going to change, NHS bosses have revealed after hospitals missed national waiting time targets for two months in a row.

Patients have had to be treated in beds on corridors during busy periods at Ipswich and Colchester Hospitals, bosses said Picture: GREGG BROWNPatients have had to be treated in beds on corridors during busy periods at Ipswich and Colchester Hospitals, bosses said Picture: GREGG BROWN

You may have already seen GPs and nurse practitioners at A&E – and soon they may become a permanent fixture, as efforts are stepped up to get patients seen more quickly and by the right person.

Physical ‘urgent care centres’ are in the pipeline at Ipswich and Colchester hospitals, with the latter in a more advanced stage as one is built as part of a multi-million pound revamp.

Chiefs at Ipswich are in the process of finding a site for theirs on the Heath Road estate.

In the meantime, the way patients are treated at A&E is changing.

On arrival, either via NHS 111 or of their own accord, patients will be triaged before being seen either by a GP, nurse practitioner or emergency doctor – depending on what is wrong.

“We are going to change the way we provide urgent and emergency care in partnership with GPs and our colleagues so that patients have a better experience and are seen as soon as possible by the right person,” Ipswich and Colchester hospital spokeswoman Jan Ingle explained.

This case for change is being made as bosses admitted current working methods are hindering their promise to patients, to see 95% within four hours at A&E.

In January, just 85.5% were seen within four hours at Ipswich and Colchester, while West Suffolk Hospital’s A&E performed slightly better with 85.9%.

This was down from 88.1% and 90.9% respectively in December 2018.

How are hospitals coping with winter pressures?

Winter pressures are biting and some patients were treated in corridors over the last two months in busy periods at Ipswich and Colchester hospitals – though only for a short while, bosses admitted.

Changes are afoot at Ipswich Hospital's A&E Picture: GREGG BROWNChanges are afoot at Ipswich Hospital's A&E Picture: GREGG BROWN

Demand is up – by 12% at Colchester alone – and medics are dealing with sicker patients, with more complex illnesses.

Mrs Ingle added: “Keeping our promises to patients to see 95% of people coming to the emergency department within four hours, is very important to us.

“This winter has been challenging with more patients needing our care and needing more intensive, high level care.

“This complexity and acuity of care for patients, added to a rise in demand for care – up 12% at Colchester Hospital – are factors in why we did not achieve the national access standard every day.

“The figures from NHS Digital describe only one type of emergency care, and if we include all levels of urgent and emergency care we are performing at a good level and are still on track to achieve the 95% national access standard for the year across the trust.”

However, West Suffolk Hospital bosses say they are performing better than last winter.

Deputy chief operating officer Alex Baldwin said: “Meeting the four-hour A&E standard is important to us, and we know it’s important to our community too.

“A&E attendances here at West Suffolk Hospital are up 6% for the year, and emergency admissions have risen by 9% which is almost double the national average.

“These performance results very much reflect these increases in demand.

“Despite us seeing and caring for more people, we are generally performing much better than last winter thanks to better preparation and planning, and to the incredible efforts of our staff.

“They continue to pull out all the stops to provide high-quality care to people, every day.”

Ambulance handover delays have also increased this winter Picture: ARCHANTAmbulance handover delays have also increased this winter Picture: ARCHANT

More ambulances held up at A&E – and some days have been challenging, bosses say

Getting ambulances back on the road is a priority for hospitals in the region, bosses said as the number of ambulance hours wasted by waiting to hand over rose again this winter.

Handing over a patient from an ambulance to A&E is expected to take no more than 15 minutes.

Ambulance crews then complete any outstanding paperwork and make sure their vehicles are clean, restocked and meet infection prevention standards.

However, in January 2019 the equivalent of 295 ‘ambulance hours’ were wasted waiting to hand over at Ipswich Hospital, 203 at Colchester and 318 at West Suffolk, up from 228, 189 and 213 the previous month.

This is down year-on-year from January 2018.

Crews have 15 minutes to restock and sterilise their ambulances Picture: SU ANDERSONCrews have 15 minutes to restock and sterilise their ambulances Picture: SU ANDERSON

Gary Morgan, deputy director of service delivery at the East of England Ambulance Service, said: “There have been some challenging days this winter and we would like to thank our staff who have worked tirelessly throughout the winter period.

“We have seen an increase in the number of more seriously unwell patients this month. Our winter plans to manage demand include a handover escalation process, where we work closely with hospitals.

“It is important to note that we have seen an improvement in handover delays at Ipswich, Colchester and West Suffolk hospitals in January 2019 compared to same month in 2018.

“As part of our collaborative working across the region, hospital ambulance liaison officers (HALOs) work in A&E departments to help manage the flow of ambulance patients arriving.

“Our HALOs assist A&E teams and our ambulance crews to handover the sickest patients as a priority.”

Ipswich and Colchester hospital spokeswoman Jan Ingle said there is a renewed focus on managing ambulance demand this winter.

“Getting emergency ambulances back on the road as quickly as possible is also a big priority for us, and we have put in place several changes at both emergency departments to try and make this happen,” she said. “These changes include much closer working with the ambulance service and a stronger focus on managing demand.”

Meanwhile, West Suffolk Hospital’s Alex Baldwin added: “We always endeavour to free up ambulance crews as quickly as we can to allow them to attend emergencies in the community, and the vast majority are.

“Our emergency department has to directly respond to the flow of patients who arrive in the back of ambulances, and these numbers are often unpredictable.

“Our emergency department nurses and doctors work closely with ambulance crews to ensure patients aren’t left waiting any longer than necessary, and to start delivering hospital care whilst they are waiting, but handover times can, and will still be, a challenge in busy periods.”

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