Agenda item

Report of the Chief Executive of the University Hospital Trust detailing the performance of the Emergency Department and the winter plan , attached.

The Panel considered the report of the Chief Executive of the University Hospital Trust detailing the performance of the Emergency Department and the winter plan.

The Director of Transformation at the University Hospital Southampton Trust (UHS), Director, People (SCC) and Chief Officer of the Southampton City Clinical Commissioning Group were in attendance and, with the consent of the Chair, addressed the meeting.

The Panel acknowledged that nationally the issue of performance against emergency department targets had received a substantial amount of press coverage recently.  It was explained to the Panel that the issue was a top priority for all of the local health providers and that a plan had been developed to help ensure an improvement in achievement against the targets.

The Trust explained that December and January had been difficult months for the hospital with outbreaks of norovirus and a winter vomiting bug that had added a heavy strain on the efficiency of the Hospital overall, due to the need to quarantine areas off and undergo deep cleaning where incidents of the viruses had occurred. There had been additional pressure on the Emergency Department (ED) and performance had slipped away from the target.  There had been no incidents of ambulances queuing in order to release patients into the ED.  The Panel noted that the local 111 telephone service had directed 4% of callers to the ED as opposed to a 6% national average. 

The Panel discussed the benefits of having a dedicated discharge suite at the Hospital and potentially another minor injuries unit onsite.  However, it was explained that the practice of having a dedicated suite for discharge had been investigated previously and proved impractical in the past with regard to both space and efficiency.  It was explained that a minor injuries unit on the same site, as well as the ED would potentially draw in additional clients and reduce the efficiency of the service. 

The Panel discussed the staffing levels of the department and understood that there was little or no issue with recruiting nurses and consultants to the ED and that the main difficulties related to recruitment of junior doctors.  Work continued to be undertaken to ensure a clear flow of patients through the Hospital in order to avoid peak arrival times to the ED.  It was noted that 92% of patients needed no further support when they were discharged from hospital. 

More complex discharge cases were assessed with an onsite social care team.  It was explained that the team looked to ensure that any discharge from hospital was both efficient and safe, making sure that the necessary support was in place.  The Panel were informed that it was the intention, where possible, to release patients back to their own homes and not into temporary care home where assessment would be made.  It was noted that the action plan looked to increase the speed of process to discharge patients with more complex needs efficiently and that this would resolve some of the issues relating to blockage. Progress on this is beginning to be seen.

Overall the key issues that required continued focus were balancing the staff over peak times and enabling more weekend discharges alongside seven day working through the Better Care Plan,

RESOLVED that forthcoming reports to Panel focus on specific topics relating to the Trust’s performance against the targets for Emergency Departments and in particular the report to the March meeting of the Panel should focus on aspects relating to the release of patients with complex needs, simple discharging and resolving staffing issues