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NHS Greater Glasgow and Clyde welcomes support to improve performance

Tuesday, March 3, 2015

NHS Greater Glasgow and Clyde welcomes support to improve performance

NHSGGC has welcomed the additional £5 million investment announced today by the Cabinet Secretary for Health and Wellbeing to reduce the time patients are waiting to be admitted or discharged from our Emergency Departments.

Staff at the Royal Alexandra Hospital in Paisley are already working with a Scottish Government support team to improve patient flows and already we are seeing some tangible improvements.

Now this joint collaboration between NHSGGC staff and the Scottish Government support team will be taken into the Emergency Department of the Western Infirmary.

The learning from across Scotland has already helped identify a number of areas of improvements.

These include:

  • Senior management providing on-site leadership to support the teams on the ground respond rapidly to peaks in demand.  These arrangements have taken immediate effect. 
  • establishment of an early morning daily ‘huddle’ involving medical, nursing, admin, portering and facilities staff to plan for the day’s anticipated demand and that they are working seamlessly together 
  • roll out of criteria-led discharge 
  • additional support for junior doctors to ensure prescriptions are ready for patients being discharged 
  • increased discharge lounge activity 
  • establishment of a multi-agency ‘hub’ to ensure that barriers to discharge are removed 

Andrew Robertson, NHSGGC Chairman, said: “I am acutely aware of the pressures on staff and the commitment of staff in these challenging times. I am also determined to ensure we all work together to find the solutions and to share learning across NHS Scotland to achieve the improvements that will benefit our staff and our patients. 

“The support team have found staff to be very dedicated and committed to ensuring that patients are seen and treated quickly and effectively.  

“They have had a positive response from staff as they work together, using what has been learned in recent months from across Scotland, to improve patient care.  

“Now we will, with the support team, adopt this approach at the Western Infirmary which has experienced a significant dip in performance and cascade the learning across our other sites. 

“These improvements will be further supported by the provision of the additional £5m of Scottish Government funding to invest in initiatives such as intermediate care beds for patients who do not require to stay in hospital but are unable to return home.” 

Our investigations show that the pressures currently being experienced in NHSGGC are in part due to a rise in the number of patients presenting at our A&E departments – 6586 more patients came into our A &Es between the same period (April 14 to January 15) last year.  

Furthermore the proportion of people with significant illness who have come to our A&E's increased significantly. 

The number of people referred by a GP and admitted has also risen by 1196 compared to the same time last year. These are real pressures of demand and we are having to work hard to meet these challenges. 

Our analysis shows that the increased number of patients being admitted are also requiring a longer stay in hospital due to the complexity of their health problems. 

Compounding these extra pressures has been an increased prevalence of flu with 185 cases reported in January 2015 compared to one in January 2014 and respiratory problems in the community. 

These factors together with the delays in patients being discharged from hospital are contributing to the pressures that our hospitals are experiencing. 

We also know some of our patient flow problems result from the physical restrictions due to working in older hospitals, such as the Western Infirmary and Victoria Infirmary. 

It’s evident that patient numbers attending some emergency departments are more than these units were designed to cope with. 

The new South Glasgow University Hospital and new Children’s hospital will replace services at the Royal Hospital for Sick Children at Yorkhill, the Southern General Hospital, Western and Victoria Infirmaries and Mansionhouse unit and have been designed to provide the optimal flow of patients through the hospital. 

The "front door" unscheduled care capacity at the new hospital will be greater than the combined unscheduled care "front door" capacity of the Western, Victoria and Southern General hospitals. 

These two new hospitals on the south Glasgow campus open in May. The other main emergency receiving hospital in the city will be the Glasgow Royal Infirmary where we are increasing capacity by more than 40 beds and increasing emergency and assessment staff levels.

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