Huge partnership effort leads to improved winter performance

Health and care leaders in the county have hailed unprecedented partnership working and an immense effort from front-line NHS and social care staff for significant improvements in service performance this winter.

In the seven months from June 2017, performance against the national maximum 4 hour waiting time standard in the county’s emergency departments was one of the strongest in the region.

Performance over the four winter months to the end of February 2018 stood at 91.1% compared to 78.2% for the same period last year.

In January, the Trust was ranked 15th out of 137 nationally for its performance in this area.

There was a substantial reduction in delays for patients fit to leave hospital, a 78% reduction in ambulances waiting over 30 minutes to transfer patients into hospital and considerably fewer cancelled operations.

Dr Andy Seymour, Clinical Chair at NHS Gloucestershire Clinical Commissioning Group and Chair of the A&E Delivery Board, attributes this improvement to a stronger joint Winter Plan. He said:

“In the face of significant pressure during the difficult winter months, health and social care staff have worked tirelessly together to deliver safe and effective care to local people.

Put simply this is about making sure the experience of patients is the best it can be and ensuring people get the right care, in the right place at the right time.”

NHS and social care staff have helped patients to avoid unnecessary visits and stays in hospital and reduced delays in a range of ways. These include:

  • GP surgeries offering a greater number of ‘on-the-day’ appointments
  • the ambulance service providing clinical advice and treating patients at the scene
  • community staff seeing more patients at home or close to home
  • new hospital based assessment services significantly reducing delays in the Emergency Department
  • more GPs working in the emergency department
  • mental health professionals working in the emergency department, and alongside GPs and emergency services, to offer early support and;
  • more social care staff working in hospitals to assess patients and an increase in home care.

An additional 1,500 GP appointments were available each week during the winter period and there were more monthly patient contacts than ever before (over 2,000) with the community rapid response service (response at home or the community within an hour).

A key part of the Winter Plan this year was a pilot project to organise trauma and orthopaedic services differently, with patients who require orthopaedic trauma surgery being treated at Gloucestershire Royal Hospital, with planned operations, such as hip or knee replacements, being carried out at Cheltenham General Hospital.

The result has been fewer patients having planned orthopaedic operations cancelled and 20% more operations taking place in January 2018, compared to January 2017.

Following initial findings, the pilot project will now be extended so that further evaluation can be done on the scheme.

The learning from the pilot scheme will inform future thinking about how Centres of Excellence could be developed across the two large hospitals.

Dr Mark Pietroni, Specialty Director for Unscheduled Care at Gloucestershire Hospitals NHS Foundation Trust said:

“The Trust is committed to delivering the very best care for every patient. I am incredibly grateful to our staff and those working across health and social care, who have embraced new ways of working to improve outcomes for our patients this winter.

Not only have we improved performance against the national 4 hour A&E standard, but the experience of patients has also improved.”

Candace Plouffe, Chief Operating Officer at Gloucestershire Care Services NHS Trust, said:

“We are very proud of all our staff across the Trust working within the community and in community hospitals.

In the community, more staff have been employed to support people to remain in their own homes instead of going into hospital and to help patients leave hospital sooner.

Our Community IV Therapy Service, which is available 7 days a week, has helped to support this. The service has also enhanced patient safety by reducing the risk of infection and improved patient choice by enabling people to stay in their own homes.

The 24 hour a day, 7 day a week Community Rapid Response Service provides urgent care for adults who require community based care. This winter, it saw 70 new patients each week; patients who may otherwise have needed a stay in hospital.”

Colin Merker, Acting Chief Executive of 2gether NHS Foundation Trust, said:

“There’s no doubt that services, teams and individual colleagues have worked tirelessly side by side this winter. From our perspective, closer working alongside GPs and the hospital emergency departments to provide support to people experiencing mental illness, as well as working alongside our emergency service colleagues to support people in acute mental distress, has paid dividends.

I’d also like to thank all of our staff across the health community for putting their service users and patients first by having their flu jab, and for going beyond the extra mile to ensure services continued to run 24/7 during the periods of severe ice and snow.”

Councillor Kathy Williams, cabinet member for adult social care delivery at Gloucestershire County Council, said: “Over the last year, we’ve made great strides in working more closely together across health and social care and that’s really paid off this winter. Our teams give it their all responding to winter pressures, to make sure people get the best care.

There is plenty more planned this year to build on improvements and help people avoid hospital stays where possible and leave hospital safely when they’re well enough.”