Airedale NHS Trust

Reconfiguring unscheduled/scheduled service and training to achieve 2009 compliance

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Overview

By establishing scheduled and unscheduled adult care teams Airedale NHS Trust will work 24 hours a day every day across conventional speciality boundaries. These teams will be made up of doctors from diverse backgrounds, highly skilled nurses and health care assistants. The proposed project centres on a two team approach: TUSKERS (team for unscheduled care and emergency responses) and SPECTORS (scheduled planned care team of organised responders). This team working pilot builds on and expands the Australian model of specialty specific training (emergency medical teams) to promote learning beyond narrow specialities and to work towards WTD 2009 compliance.

Organisational background

Airedale NHS Trust is a 400 bed district general hospital in West Yorkshire serving a mixed urban and rural population of approximately a quarter of a million people. There is a close collaboration between primary and secondary care for emergency out of hours care (urgent care improvement team). An awarding winning trust, with high ratings in consumer surveys, junior doctor feedback and medical student evaluations, it is looking to extend its track record of innovation by reconfiguring unscheduled and scheduled service and training.

Challenges

At April 2006 the Trust has been externally evaluated as making progress towards compliance with WTD 2009 but still has significant distance to travel. Airedale service delivery groups are working on plans to improve compliance. This is challenging on a number of levels such as incomplete middle tiers and the reduced availability for training. The solutions being modelled vary significantly in scope and risk introducing increased inequity. The TUSKER and SPECTOR model provides a radical approach to promote equity, appropriate access to training and to work towards WTD compliance.

Specific objectives of the pilot

Airedale’s specific objectives are to:

• Achieve WTD compliance
• Identify innovative and challenging ways of establishing discreet scheduled and unscheduled adult care teams which will work 24 hours a day, every day across conventional speciality boundaries and be made up of doctors from diverse backgrounds, highly skilled nurses and healthcare assistants
• Provide experience to trainees at an early stage of their training that is in turn diverse and specialty specific
• Be trained in competencies required for delivering high quality, specialist emergency care to a wide range of patients
• Separate scheduled from unscheduled training experience
• Enable quality of intensity and acquisition of skills in emergency care across all specialties
• Reduce interruption of speciality training by unscheduled activity
• Provide appropriate and timely care for patients presenting with scheduled and unscheduled care needs
• Support appropriate escalation
• Match tasks to skills for all members
• Provide an environment for non-medical role development and delivery
• Challenge traditional speciality and professional divides
• Be enriched by working in a radical and innovative atmosphere.

Delivering compliance

This pilot will

• Learn and interface from previous projects that have built on team working
• Reduce workload for medical training grade and equivalent grades
• Improve communication across and within multi disciplinary teams, and Improve patient safety
• Ensure that new roles follow best practice and professionally appropriate requirements relevant to the role
• Be cost neutral or cost reducing initiatives.

The pilot commenced in July 2006 and will be complete in December 2007.

Latest update and resources

July 2006 - Recruitment to the roles of consultant lead and implementation manager is currently taking place.

July 2006 - Initial consultations with staff have commenced.

Related Resources

Click on the links below to view information on Airedale's data collection methods:

Data Process
Stakeholder Engagement
Data Collection Form
Data Collection Form - Pharmacists

Airedale's Quarterly Project Update