Shropshire A&E overspill policy led to cancelled operations - report
Patients in Shropshire had operations cancelled because day surgery beds were used as accident and emergency overspill last winter, according to a report.
A 2019-20 Winter Plan, due to go before health commissioners this week, says this tactic “only adds to the backlog”, and promises to improve patient assessment and avoid unnecessary admissions.
But the document, prepared by the Shropshire, Telford and Wrekin and Powys A&E Delivery Board, praises the Shrewsbury and Telford Hospitals NHS Trust (SaTH) for discharging patients over the weekend, saying this “maintains flow” but requires extra staff.
Shropshire’s two NHS clinical commissioning groups will discuss the report at upcoming meetings.
The Winter Plan authors write that winter 2018-19 saw a “significant amount of escalation” into the day surgery units (DSUs) at both the Princess Royal Hospital and Royal Shrewsbury Hospitals.
“It is important that, whilst ensuring we minimise corridor care and patient waiting times, that the system does not tackle increases in demand to the detriment of other services,” the report continues.
“As a result of the above, escalation into DSUs saw cancellations for patients on the day of surgery, which goes against the trust’s desire to offer a positive patient experience.
“It also only adds to the backlog of work that needs completing and builds pressure within planned care.”
It says the 2019-20 Winter Plan “has a focus on reducing the number of patients arriving at the front door in the first instance”.
“For those who do arrive, placing greater emphasis on same-day emergency care, frailty assessment and management at the front door, effective 24-hour streaming, and other ways that allow the trust to see, treat and send home patients without the need for admission is seen as a priority.”
However, in a section titled ‘What went well’, the report praises SaTH for for discharging patients at the weekends to “maintain patient flow”, but points out that this requires additional doctors and liaison nurses.
“Funding for this this winter was suggested as a priority in order to continue to develop this positive work,” it adds.
The report adds that, last winter, both Shropshire Council and Telford and Wrekin Council reduced the number of long stays in community facilities, and the Midlands Partnership NHS Foundation Trust helped by “increasing the number of beds available for cognitively impaired patients, who would otherwise have represented a delayed patient stay at SaTH”.
The governance board of the Telford and Wrekin CCG is due to discuss the Winter Plan when it meets on Tuesday, November 12. Shropshire CCG’s governing body will meet the following day.
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