NHS Greater Glasgow has unveiled its vision for redesigning inpatient care and bringing services in line with the best performing hospitals throughout the UK.
The vision sees a complete overhaul of the way services are organised ensuring care is entirely focused on patients' medical needs at every stage of their hospital stay.
After more than a year of detailed analysis by senior doctors across the full range of medical specialties, working together with the city's planners and expert advisors, a series of proposals have been published today, which include:
Brand new emergency medical complexes are proposed to ensure that in the first critical 48 hours after emergency admission to hospital, patients have rapid access to the full range of diagnostic tests and are fast-tracked to the appropriate treatment – cutting down lengthy trolley waits in A&E. Each complex will include an acute assessment area, emergency outpatient clinic and acute admissions ward.
Also in the new set-up, patients will no longer have their care provided in a single ward, e.g. a hip replacement patient remaining in an orthopaedic ward, but after surgery will transfer to new dedicated rehabilitation facilities where they will undergo intensive treatment supported by the multi-disciplinary team to ensure rapid recovery.
Around 200 beds will be re-designated to create the new emergency medical complexes and the rehabilitation units will be created by bringing together around 500 rehabilitation beds currently spread throughout general wards across our hospitals.
The proposals have been developed as part of NHS Greater Glasgow's work to look at future patterns of healthcare and identify new service models. Whilst the main focus has been on how inpatient care should be organised for 2010 and beyond – in line with our £750million hospital modernisation programme – this work has also helped to estimate future acute bed numbers.
As well as adjusting the city's beds numbers to reflect predicted changes in service pattern, the exercise has also taken into account predicted changes in demand for our services over the next decade – both in terms of anticipated extra demand (e.g. in the drive to reduce lengthy waiting times) and also where fewer beds will be needed.
New surgical techniques mean that many operations are now less invasive – often they can be done by day surgery or even in outpatient clinics. Research tells us that patients prefer to go home after surgery whenever possible.The number of operations done on a day surgery basis is on the increase. Over the next decade day surgery and day case treatments and investigations are expected to rise further with the opening of our new state-of-the art hospitals at Stobhill and Victoria.
Brian Cowan, Medical Director, NHS Greater Glasgow said, "In order to forecast how many day cases might be done by the time our new developments are open, we have compared our performance with other similar hospitals.By carrying out in 2010 the same levels of day cases that others are achieving now we predict that up to 10,000 more patients could be treated as day patients – and would therefore have no need for a bed."
There are other areas over the next few years where we expect to change our ways of working to become more efficient. The trend for shorter lengths of stay is also expected to continue.Again, by comparing ourselves with other top performing hospitals throughout the UK, the indications are that over the next ten years it should be possible to further reduce lengths of stay.
Proposed changes in the way long stay patients are cared for have been included in our forecast too. There are groups of patients with very long stays who do not need to be in hospital - it would be better for these patients to be cared for in the community.In line with the development of our new hospitals we will develop plans to ensure that these alternative community services are available for patients.
When taking all these predicted changes together, NHS Greater Glasgow has calculated that we shall need between 3021 and 3200 acute beds across the city.
Brian Cowan said, "Developing proposals for service redesign and the related requirement for inpatient beds for a decade in advance is a difficult and challenging endeavour. The proposals which are presented today show a range of options for bed numbers based on varying levels of efficiency and a number of assumptions about future demand. We want to test with a wider group of clinical colleagues our proposed bed number projections and our plans for the radical changes in the way patients should be treated.From today, we will begin this process and report our findings back to the Board in due course."
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