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Unscheduled Care

Since 2004, people who experience the most serious 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. These patients receive what is called ‘unscheduled’ medical care. This is currently provided by the Vale of Leven Hospital’s Medical Assessment Unit.   Unscheduled medical care is provided to 6,300 patients each year at the Vale and is supported by access to anaesthetic cover.  This is in place because a small proportion of the patients receiving this type of care at the Vale may be at higher risk of becoming more seriously ill and requiring urgent treatment.   There have been four reviews of anaesthetic services at the Vale of Leven Hospital, the most recent in the summer of 2008. All concluded that anaesthetic services are not sustainable 24 hours every day. This means that we need to change the way in which unscheduled medical care is provided at the Hospital.    The challenge is to provide unscheduled care in a way which is clinically safe and allows as many patients as possible to be treated at the Vale of Leven Hospital.  Independent experts who reviewed services in August 2008 thought that a model of care could be developed which would allow between 36% and a maximum of 83% of unscheduled medical patient care to be retained at the Vale of Leven.    Based on the detailed work we have undertaken since receiving the review team’s recommendations, we are proposing that new service arrangements be introduced:  

  • The Medical Assessment Unit will become a Consultant Supported GP led Acute Unit and will provide unplanned medical care to between 4,400 and 5,300 patients every year – between 70% and 80% of the current level
  • The Unit will be operational 24 hours a day and be staffed by General Practitioners (GPs) trained to provide appropriate hospital care; they will receive advice and support from hospital consultants if it is required
  • Patients will be screened by ambulance crews, local GPs and in the Vale Hospital using clinical protocols and a clinical scoring system. If it is safe, and clinically appropriate, patients will be cared for in the Vale. If patients are more seriously ill and are at greater risk, potentially requiring higher dependency care, they will be taken to the A & E at the Royal Alexandra Hospital. The scoring system will be a further development of the one which is already in wide use in the local area.
  There are currently 5,000 patients from the Vale of Leven catchment area who attend the A & E service at the Royal Alexandra Hospital. These patients will continue to receive care there.    Our proposals for unscheduled medical care would mean that between 1,000 and 1,900 of the 6,300 who currently attend the Vale Medical Assessment Unit will also need to attend the A & E in Paisley. This will include, for example, people who have suffered a stroke, epileptics suffering convulsions, people with serious gastro-intestinal bleeding and people who have overdosed on drugs.   The Health Board are committed to working with the Scottish Ambulance Service to provide the extra funding needed to ensure an increased level of paramedic services including vehicles to enable the rapid transfer of patients around the clock.   Our Vision for the Hospital is that there will be no change to its Minor Injuries Unit. This treats 9,000 patients each year who have suffered conditions like wounds, fractures, dislocations, sprains, burns and eye injuries. 

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