Improving emergency care

The Trust has identified improving care for the emergency patient as its top priority.

Steps are now being taken to start doing this ahead of the winter - with a particular focus on University Hospital of North Durham.

Diane Murphy, clinical director of service transformation says, "The Trust's accident and emergency services see and treat over 120,000 patients each
year, which is way beyond the capacity the departments were built for.

"This means that there are times when patients have long waits for treatment, and are waiting longer than necessary in ambulances to come into the departments. This means they have a
poor experience of care."

This is a particular issue at Durham, but, as a single Trust, also has a significant impact on Darlington Memorial Hospital. Around 800 patients a year are transferred from UHND to
Darlington.

UHND receives more patients by emergency ambulance than any other hospital in the North East.

During the summer, discussions among clinical teams have intensified around changes that need to be made to provide better care for the emergency patient.

Diane says, "Although the challenge is mostly around medical patients, this also affects how we manage surgical patients."

This September, a series of actions is being rolled out to improve the service we offer, which include:

• Converting a surgical ward at UHND (ward 14) to medicine to increase medical beds more in line with the numbers of patients requiring inpatient care - and reduce the medical patients who are treated on surgical wards.
• Extending our medical assessment unit (for patients in the first hours of their admission) to cover two wards (wards 3 and 4) instead of one.
• Creating a clinical decision unit (on ward 13) where patients who may need surgery can be seen and assessed, and decisions made about their care.
• Changing some patient pathways to ensure that patients are seen in the most appropriate speciality, cutting out duplication and in line with our 'Right place, right time, first time' strategy.
• Over the coming months, further changes will be rolled out, including extending space in both ED departments.

Diane Murphy added, "We believe these changes will significantly improve our service. But it isn't just about the facilities, it's also about having the right staff in place, and the right ways of workings to make sure that patients get the right care at the right time."