New working model aims to take pressure off Shropshire A&Es

By Lisa O'Brien | Shrewsbury | Health | Published:

New ways of working are being tested at Shropshire's two main hospitals this week in a bid to relieve pressure on the county's A&E departments.

The Shrewsbury and Telford Hospital NHS Trust (SaTH) says its emergency and acute medical care teams have been working with colleagues to identify ways to improve how and where patients are treated as they enter both Royal Shrewsbury and Telford's Princess Royal hospitals.

Last month, the Care Quality Commission said it had taken further urgent action with regard to the emergency departments, following an inspection in April.

The departments have suffered from staffing issues, soaring demand and have regularly missed the Government's four-hour patient waiting target.

The trust's board recently approved plans to almost double the number of full-time nurses at the emergency departments – from 78 to 149 by 2021/22.

SaTH says redesign work has been done so that patients can be seen by the right senior clinician for their needs more quickly and be cared for in a better environment.

The new model is being introduced this week and next at PRH and RSH.


During the two 'Acute Medicine Start of Change Weeks', teams will test out the changes they have been developing and plan to continue those that work well.


As part of the new model, the clinical decisions unit will become an acute medical assessment (AMA) area with a mix of beds and AMA trolleys to assess patients ‘at the front door’.

The trust says it means patients will be seen by a senior clinician more quickly.

An acute medical unit ward will work for patients requiring direct admission.

The acute medical clinic and same day emergency care teams will look after patients who come through AMA and can be treated and sent home on the same day.


Protected ward areas for emergency patients will ensure patients requiring a bed get to the correct ward where they can be treated by the right staff more efficiently.

The skill mix of staff, extended hours of service and increased weekend cover across acute medicine will also be tested.

The trust says this will help shape the correct staffing models required.

Systems and processes will also be improved, including work on board and ward rounds.

Nigel Lee, chief operating officer at SaTH, said: “We are looking forward to putting into practice all the developments we’ve been working on for our Acute Medicine Test of Change Weeks, and we invite the support of all specialties, disciplines and support services across our hospitals.

“Effective acute medical and same day emergency care services means improved quality, safety and effectiveness within our hospitals, so I want to ask all staff to fully support our emergency care teams in testing new ways of working to improve care for our patients.”

Staff can get involved by visiting the acute medical unit and short-stay wards to offer support or join daily 'huddles'.

Lisa O'Brien

By Lisa O'Brien
Senior Reporter - @lisaobrien_Star

Senior reporter based at Shropshire Star's head office in Ketley. Covering the Telford area.


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