Challenges & objectives

Challenges

The GP Out of Hours service (GPOOH) run by South East Health is based at each of the two hospitals, adjacent to the A&E departments. Although this service has enabled the streaming of primary care patients from A&E, there is scope for closer working.

A multi-disciplinary Hospital at Night team is in place at each site, resulting in demonstrable and sustainable success. The Medical Assessment Unit (MAU) in Hastings is adjacent to A&E but this is not the case at Eastbourne. Medical admissions currently seen and assessed in A&E will be reassessed in MAU and this suggests that joint working will benefit patients and reduce workload.

The workload of the surgical team overnight is already minimal but changes will have a positive effect on compliant rotas and enable more doctors to be available at peak times.

The aim of this project is to develop a new approach to the provision of emergency care with Urgent Care Centres that combine the skills and resources of A&E, MAU, Hospital at Night, the surgical team and GP Out of Hours service. This presents cultural challenge to each organisation, directorate and team as well as individual practitioners, but will result in an improved service to patients that will positively impact on WTD 2009 compliance.

Specific objectives of the pilot

Specific objectives of this pilot are:

• To ensure that the population of East Sussex can continue to locally access a full range of clinically safe emergency services throughout the 24 hour day, 7 days per week
• Achieving a sustainable reduction in the workload of doctors in training and equivalent grades by enhancing the roles of other staff
• Ensure that models of care are clinically viable and in addition that there is improved clinical supervision
• All medical staff to have a work pattern that enables them time to support their training needs
• To ensure full support from the executive teams of each organisation, clinicians and staff side representatives to the extent that cultural change is achievable over time
• Addressing the pressures on recruitment and retention of key staff
• While acknowledging the concerns of continued sustainability of the current full service provision on both sites, demonstrate how effective cover can be provided 24/7 to the total population
• To ensure that the overall costs are at a sustainable and affordable level for the local health economy
• To ensure that there is a clear communication plan for internal use to the organisations and the wider NHS.

Delivering compliance

This pilot will:

• Provide services locally, ensuring that all patients are able to see the right person at the right time as near to their home as it is clinically safe to
• Maintain and improve standards of care
• Create an environment in which excellence in care can flourish
• Support and inform staff through training
• Provide timely and expert emergency care
• Meet the requirements of WTD 2009.