The Scarborough health local health community project

The Scarborough health community covers a geographical area of nearly 2000 square miles with a population of 230,000 that varies seasonally. Health services are configured around a district general hospital at Scarborough, a community hospital at Bridlington with resident medical staffing together with two smaller community hospitals in Malton and Whitby containing nurse led and GP beds. Primary care services are provided by 27 local GP practices. In addition the Primary Care Trusts provide an extensive range of community services including community nursing, physiotherapy, speech and language therapy, psychology, podiatry and other professions allied to medicine.

Following a successful start to the WTD project which identified a range of benefits for patients, the workforce and organisational objectives, the team set about obtaining the evidence base. It became clear that if WTD 2009 was to be achieved then not only would the acute hospital need to change ways of working but so would the services provided in community and social care.

Data was collated looking at the pattern and volumes of admissions into Hospital.

The data showed that there is a peak of workload in the acute hospital at 3pm. Doctors in training traditionally clerk and review patients on admission and it was felt that a flatter pattern of admission in harmony with a reduction in admissions and senior clinical review on arrival would reduce doctor in training workload and be safer and better for patients.

In order to tackle such a complex problem of the WTD 2009 requirement, Andy Mooraby (WTD Project Manager) persuaded the project group to break the project down into six distinct work packages. This has provided a focus and helped with planning and ownership. The work packages are as follows:

• Removing the 3 O'clock admissions hump
• A&E Out of hours integration
• Single medical/surgical assessment team
• Review of medical training experience
• Achieving WTD "speciality by speciality"
• Optimise management of 'short' length of stay non-elective admissions.

Implementation of solutions within each work package is underway and the data/evidence will be available in mid 2007.

Further details can be obtained from andy.mooraby@acute.sney.nhs.uk or on the Scarborough Health Community pages on the healthcare portal http://www.healthcareworkforce.nhs.uk/scarboroughpilot/.