Patients see benefits of NHS Derby and Derbyshire winter planning

People across Derby and Derbyshire are already benefiting from a series of projects aimed at improving access to care and boosting hospitals' ability to discharge patients.

The multi-million pound NHS Derby and Derbyshire initiatives range from extra beds to extra ambulance crews and dedicated hubs for people with respiratory illnesses.

One of the early successes is a re-opened ward at Florence Nightingale Hospital in Derby. The community hospital's extra 23 beds are part of an initiative to add beds across Derby and Derbyshire for patients who no longer need the high level of care available in a large acute hospital but require extra assessment before discharge or more care than they can receive at home.

University Hospitals of Derby and Burton Executive Chief Operating Officer, Sharon Martin said opening the extra beds was part of a system-wide effort to improve patient flow through the acute hospitals: "These beds are for patients who are ready to be discharged, but have not yet been assessed for extra support they will need outside of hospital. That's an important step, and doing it away from the acute hospitals means an acute bed is freed up, and the patient is in a better environment to continue their discharge process.

"This is part of a system-wide response to the challenge of discharging patients, which is affecting every part of health and care. The acute hospitals need beds so they can admit the most poorly patients and carry out planned procedures that require acute post-operative care.

"Ultimately, that means fewer people will be waiting for care, and that's good for everyone."

Extra community beds

One of the most important parts of the investment encompasses five separate projects to add extra beds in community hospitals, hospices and care homes.

As well as the extra beds at Florence Nightingale Community Hospital, more beds will be made available at Ilkeston Hospital, and in social care settings.

Joined Up Care Derbyshire's Planned Care Programme Board Chair, Dr Hal Spencer, said the extra beds would help to get patients out of hospital more quickly, improving their care and freeing up acute beds for others: "These are patients who no longer need the high level of care our acute hospitals – Royal Derby and Chesterfield Royal – provide, but they may still need some level of care or be awaiting an assessment of their needs before returning home."

Dr Spencer, who is also chief executive of Chesterfield Royal Hospital, said: "These extra beds at Florence Nightingale, Ilkeston Hospital, Ashgate Hospice and some care homes will help patients at both our acute hospitals, as we're all working together as we face a challenging winter."

The project to re-open a currently empty ward at Ilkeston Hospital will create 14 extra beds to relieve pressure on hospital wards this winter. Derbyshire Community Health Services is opening the ward and working with independent provider Community Healthcare Services to staff the extra beds.

Hubs for same day urgent presentations

DHU Healthcare is close to opening the first two hubs to support GP practices in treating same day urgent presentations. These GP-led hubs are designed to increase the capacity and clinical capability of primary care, which should reduce the demand put on other parts of the system.

The two hubs, at Ashgate Hospice and Derby Urgent Treatment Centre, would help patients get access to same day urgent care more quickly, this includes symptoms of respiratory illness, which has increased significantly in the last fortnight. The hubs can see adults and children.

They will be supported by a Clinical Navigation Hub, which includes a multi-disciplinary team of clinicians who can assess patients who have called 999 or 111 and whose condition is not initially considered to be life-threatening or an emergency. They can speak to the patient over the phone, assess their individual needs and either give advice on how to treat the condition or direct them to the right service to receive treatment.

Aqib Bhatti, Medical Director for DHU Healthcare, said: “Whether a patient rings 111 or 999, we need to ensure that the patient receives the right care at the right place as soon as possible. Our health professionals, which include GPs, Advanced Nurse Practitioners, Pharmacists and Paramedics, will be able to make a detailed and thorough assessment of the patient to diagnose the nature of their condition and what the immediate treatment plan should be.

“The majority of the assessments will result in self-care at home, but for those who need to be seen, appointments can be made at our urgent treatment centres and GP out-of-hours hubs. This reduces the need for attendances to A&E and ambulance dispatches meaning that those who need an emergency response are seen more quickly. We can also give advice to ambulance crews at the scene if needed to provide a fully joined up response.”

Non-emergency patient transfer and ambulance liaison officers

Two other key projects involving East Midlands Ambulance Service will also improve co-ordination between ambulances and hospitals, while also adding extra ambulances to carry out patient transfers

Increasing non-emergency patient transfer capacity will make it easier to discharge patients from hospital to community settings.

Meanwhile, the appointment of hospital ambulance liaison officers (HALOs) is designed to help improve the flow of patients through Emergency Departments. The HALOs will be able to direct patients to alternative pathways, while also identifying the most urgent cases earlier.

Other winter initiatives

Other initiatives being funded this winter include extra mental health support for Emergency Departments, more clinicians in Urgent Treatment Centres and a focus on helping to discharge patients more effectively.

NHS Derby and Derbyshire Chief Medical Officer Dr Chris Weiner said the work was crucial to supporting people through winter: "This package of spending is important for the people of Derby and Derbyshire, focusing on strengthening and developing health and care services as we go into winter.

"Having extra beds in community settings will give our acute hospitals more flexibility in discharging patients who are ready, and that will benefit the whole system by freeing up capacity in the hospitals.

"The respiratory hubs will help relieve some pressure on general practices, while other investments will help improve flow through hospitals and the ability of the public to access the services they need.

"It is really important that the public understand how best to access health and care services, especially using urgent treatment centres for non-life threatening illness and injury."