Striving for Continuous Improvement in Urgent and Emergency Care

29/09/2008

Gloucestershire Primary Care Trust today acknowledged the value of the Healthcare Commission’s Urgent and Emergency Care Review published on Friday and has stressed that improvements in service have, and are continuing, to be made.

The review showed good performance in a number of areas. Overall, within Accident and Emergency Departments, the patients’ view of their experience was positive and high numbers of patients were seen within one hour of arrival.

The PCT was commended on the range of written and web based information that is available to the public.

The review report also highlighted a number of areas where further development work was required.

The review took place during 2007 and looked at performance across a range of indicators and the Primary Care Trust has pointed to marked improvements in a number of areas of service since that time.

In Out of Hours services, both the Primary Care Trust and the Ambulance Service have looked carefully at the systems concerning call priority. Additional doctors and nurses are now in place for triage at peak times.

The vast majority of calls are now answered within 60 seconds and 89% of calls are prioritised by GPs within 20 minutes compared to 51% at the time the review took place. 89% of patients who need to be seen urgently at an out of hours centre are seen within 2 hours despite an increase in use of the service.

The majority of shifts are covered by local GPs and nursing staff and there is better co-ordination of the service now with the introduction of identified shift leads.

As part of providing a high quality service, all doctors and nurses who work within the service are assessed and patient notes are now audited to ensure that the advice and treatment provided is of the highest standard.

Medical Lead for the Out of Hours Service and local GP, Dr Mike Roberts said:

“We are confident that the service as it stands is managed and staffed appropriately. The report has reinforced the view locally that we are on the right track in making the improvements to service that are needed, but we are not complacent. We want every single service user to experience high quality and timely access to care.”

The NHS in Gloucestershire has a strong track record for achieving A&E waiting time targets for the benefit of patients and the NHS and social care have been working hard together to respond to the pressures experienced in recent times.

Improvements have been made in staffing levels at different times of the day, improving arrangements for a patient’s transfer of care from hospital when they are medically fit and improving access to social care services.

Plans are in place to promote the range of services available to local people.

The PCT as the commissioner (purchaser) of emergency care services is investing nearly £2 million this year to meet new and stricter emergency ambulance targets, including Category A (life threatening) response standards.

Significant investment is also going to train more Emergency Care Practitioners (ECPs). These clinically trained professionals will be placed within the community and can respond rapidly to emergencies, give care at the scene of an incident and often reduce the need for hospital admission.

The Ambulance Service is also working hard to recruit more volunteer community first responders who can get to an incident and give life saving treatment while a crew is on its way.

These innovations are key developments in improving first line response to patients, particularly in rural areas.

Investments in technology have included the installation of satellite navigation systems in every ambulance and a new computer aided dispatch system which means the service dispatches the nearest available vehicle.

Chief Executive of Gloucestershire Primary Care Trust, Jan Stubbings

"We welcome this report which provides us with valuable feedback and information on urgent and emergency care services in Gloucestershire. It is clear that the NHS has made real progress since the review took place, but we are determined to use this report positively as we strive to make continuous improvements in service."