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| David Fillingham, Chief Executive |
Accident and Emergency Departments are busy
places. This winter in particular has been a difficult one for many hospitals,
with queues of ambulances forming outside at peak periods and lengthening waits
for patients to be treated or admitted to a bed. Indeed, across England
as a whole the performance of Emergency Departments has not struggled so much
for over a decade. The reasons for this are complicated.
Anyone who has themselves needed emergency care, or has had a relative cared
for, will know that it is a highly complex system. GPs, ambulance services,
hospitals, community services, care homes, social care, and in particular
mental health services, all have a vital part to play. If the way they
work together isn't carefully coordinated, then it’s all too easy for
the system to become “blocked”.
Bottlenecks develop so that patients have long waits to see a GP, or to be
admitted to hospital, or to be discharged from hospital, or to receive the kind
of the care they need to live independently in the community.
The evidence shows that problems in achieving an effective and smooth flow of
patients across the whole system can have very damaging consequences. The
experience of the patients and staff working in the system can be a poor
one. The outcomes of care are worse, the costs of running the system can
be much higher, and in the worst cases there could be even be deaths which
could have been avoided.
Work on improving patient flow has tended to focus inside hospitals, and mainly
on emergency care, particularly the role of A&E Departments and Admissions
Units. AQuA believes that to bring about large and sustainable benefits we need
to widen our thinking to consider all aspects of care and how they can be
connected together more effectively.
AQuA is currently carrying out a “scoping review” to identify how we can best
support our members to improve whole system patient flow during 2016/17. We are
working closely on this with other organisations, such as the Emergency Care
Intensive Support Team and the North West Utilisation Management Team, and are
also receiving support from the Health Foundation.
We will be looking at the latest evidence base, considering best practice
elsewhere, and seeking to identify change principles and interventions that
will improve the flow of patients across the whole health and social care
system.
We are keen to hear the ideas and suggestions of AQuA members, and in
particular to know about any initiatives which are already seeking to address
this difficult challenge.
Please do
get in touch with your thoughts and comments via aqua@srft.nhs.uk or tweet
us @AQuA_NHS.
