Hospital bosses say maximum wait times are reducing handover delays at Worcestershire A&Es.
Worcestershire Acute Hospitals NHS Trust wants no ambulance to wait longer than 45 minutes to transfer patients into its hospitals.
This started with a target of four hours, decreasing gradually to 45 minutes.
DELAYS: Ambulances outside Worcestershire Royal Hospital (Image: Phil Wilkinson-Jones/LDRS)
“We’ve seen some very, very long wait times in Worcestershire and took a view that we were going to set some ambitious targets,” said the trust’s chief operating officer Chris Douglas.
“Not infrequently we were seeing wait times of eight hours, so to go straight to 45 minutes didn’t seem realistic.
“Four hours as a starting point seemed not unreasonable.”
He said figures show the maximum wait times are having an impact at Worcester’s Worcestershire Royal Hospital (WRH) and have “effectively eliminated long handover waits” at the Alexandra Hospital in Redditch.
Average handover times have gone from 74 minutes to 46 at WRH, and from 39 minutes to 16 at the Alexandra.
“Worcester has more challenges and there are a lot more specialist facilities here,” said Mr Douglas, “but it is working.”
Reducing the number of ambulances waiting outside the hospital is a complex matter.
Part of that is reducing the number of patients being brought to A&E in the first place.
West Midlands Ambulance Service (WMAS) uses a ‘call before you convey’ process which sees crews call ahead to see if a patient could be taken to a community-based service or another part of the hospital such as same-day emergency care (SDEC) or the medical assessment unit.
Mr Douglas said this means patients are “accessing the care they need in a more rapid way”.
“Then it’s about managing the flow in and out of the emergency department,” he said.
“All of this eases the pressure on the ED because these services either didn’t exist or were overwhelmed.”
Mr Douglas said there have still been record attendances in A&E but thanks to a greater turnover of patients, it has been less crowded.
Over 80 percent of patients at the Alexandra and 70 percent of patients at WRH were seen within four hours last week, compared to 58 percent and 54 percent respectively before the initiative was launched.
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The acute trust is also implementing a ‘release to respond’ policy alongside WMAS, which should free up ambulance crews to visit more patients and allow them to go home on time at the end of their shift.
Another part of the puzzle is how quickly patients are discharged from the hospital to free up beds – this involves working with other trusts, social workers, and others depending on whether a patient is going home, to a community hospital bed or elsewhere.
Mr Douglas said there are challenges working with partners but these are “not insurmountable within a digital-first NHS”.
