Phase 1

Hospital at Night Extension

To meet these challenges the Countess of Chester plans to further modernise services by building on its existing strengths. The experience gained from previous team working projects will enable role extensions for non-medical clinical staff and the promotion of a culture of cross cover beyond traditional medical speciality boundaries.

Challenges

The planned reconfiguration in the existing service will positively impact on compliance. The Trust has undertaken an in-depth audit of out of hours working across specialities to benchmark current compliance by measuring against previous team working pilot sites. A full shift system has been introduced along with cross cover arrangements for minor surgical specialities. Both inter-trust and intra-trust cross cover arrangements are incorporated bringing Countess of Chester to WTD 2004 compliant cross Trust. Accident and Emergency is already 2009 compliant. Using a competency based approach this skill based model will enable sustainability and compliance to 2009 and continues to develop the nursing and medical team.

Specific objectives of the pilot

Countess of Chester’s specific objectives are to:

• To facilitate sustainability in compliance in 2009 levels and deliver a smooth transitional change process
• To achieve a sustainable reduction in the volume of work, and the level of utilisation of Junior Doctors in training to include cross boundary multi professional team working
• To formulate actions plans to enable clinical teams to meet internal and national targets and objectives
• To develop jointly agreed cross-divisional competency frameworks for multi professional teams both clinically and managerially
• Develop jointly agreed policies and patient pathways and robust audit criteria to measure productivity
• Develop a proactive communication strategy focusing both internally and externally throughout the project
• To ensure that the quality of patient care is sustained by fundamental changes in service redesign and workforce planning
• Anticipate changes in increased dependency, complexity, severity of illness and age of patients arriving in hospital showing the implementation of improved admission diversion schemes within Primary Care.

Delivering compliance

The expected benefits and outcomes from the pilot are:

• Compliance with EWTD
• Improved team working
• Improved quality training and development opportunities
• Safer working patterns incorporating rest periods
• More timely care for patients
• Improved quality of care provided by the most appropriate person
• Improved coordination in delivery of care to patients.

Phase 1 duration: June 2006 - June 2007