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A New Model For Unscheduled Care

Since 2004, people who experience the most serious conditions, such as injuries through accidents or sudden illness, have been transported directly to the Accident and Emergency (A&E) service at the Royal Alexandra Hospital in Paisley.  There are also other types of patients whose condition is not as serious but still need swift assessment and treatment before possible admission to hospital.

At the moment around 6,300 such ‘unscheduled’ or ‘unplanned’ patients go to the Vale of Leven Hospital.  Anaesthetic cover is provided by locums out of hours as a small proportion of these patients are at risk of becoming more seriously ill and requiring urgent treatment onsite or immediate transfer to the RAH.

Four separate reviews have concluded that anaesthetic cover cannot be sustained at the Vale 24-hours a day and service arrangements will therefore need to change.  This will be done in two ways: by diverting some of the most ‘at risk’ patients currently attending the Vale to the RAH, and changing the staffing arrangements for those patients who remain (additional capacity is being provided at the RAH to receive the patients who will go there).

Examples of patient journeys differentiating between unscheduled patients who would go to the Vale and those who would go elsewhere are shown the attached graphic.  Those most at risk of further deterioration – around 30% of current admissions - will, through a carefully worked out selection protocol, be taken to the RAH for their care (or the Golden Jubilee National Hospital if they have a particular type of heart condition, or the Western Infirmary if they need clot-busting treatment for a stroke).

Care for the majority of patients, who will continue to use the Vale, will be provided by teams led by Consultant Physicians and supported by GP Principals and GP Specialty Trainees without the need for anaesthetic cover.  Consultants will be onsite ‘in hours’ during the week and provide ward rounds at the weekend.  The Consultants will be on call for advice in the evenings, with GP Principals leading onsite medical cover at these times.