Challenges & objectives

Challenges

At the Trust, the development of planned patient pathways in both acute and emergency situations will provide opportunities to ensure staff have the correct skills and competencies at all stages of their care. To achieve this, different models of service provision are being developed including the introduction of Planned Care Management Teams and an Acute Response Teambuilding on the Hospital at night model. The teams on both sites will continue to be led by Site Nurse Practitioners both day and night.

A recognition that there will be a reduction in specialist knowledge in some areas of practice is being addressed by the identification of staff for training in the new roles, giving an opportunity to work more closely with Site Nurse Practitioners and recruiting trained staff to provide elements of the agreed pathways. This builds on the trust’s already established commitment to multi-professional working and increases the flexibility of skills available to work towards WTD 2009 compliance.

Specific objectives of the pilot

Guy’s and St Thomas’ NHS Foundation Trust specific objectives are to achieve WTD compliance by:

• Separating acute (unplanned/unpredicted) care from planned care
• Introducing new care pathways with rapid access to diagnostics and therapies to provide rapid access to appropriate care and prevent admission.
• Providing additional new and extended scope practitioners to increase capacity
• Improving clinical pathways in both acute and elective cases.

Delivering compliance

This pilot will:

• Introduce planned care pathways that reduces junior medical involvement in routine clerking, routine tests and discharge summaries
• Manage admission and discharge more effectively
• Introduce new roles and extended roles
• Provide development and training for current staff and increase recruitment of other trained staff
• Support junior doctors by reducing the intensity of workload, further improving training and focussing medical skills where they are most needed.
• Ensure compliance with the 48 hour week for WTD 2009.