~ Wednesday, 21 March 2012
That was the message from the Health Minister Edwin Poots as he unveiled his plans to tackle Emergency Department waiting times. The Minister spoke to delegates at the Ward Sister Conference in Mossley Mill, Newtownabbey.
The Minister said: “I will not accept poor or sub-standard services in our hospitals. The proposals in the Transforming Your Care report, represent a radical change to how we currently deliver health services. However providing safe and effective services means looking to the here and now, as well as the future and we need to ensure that the services that are currently being delivered serve all of our citizens well.
“I want to see a significant improvement in the performance of emergency departments across Northern Ireland and that can only be achieved through a broad approach, involving all areas of the health service.”
During his keynote address, the Minister announced the establishment of an Action Group tasked with driving down waiting times and improving the standard of care received by patients.
The Minister said: “The Health and Social Care Board, along with the Public Health Agency will establish an Action Group with immediate effect. I want to know that all parts of the HSC are applying known, evidence-based good practice and I have asked for a robust plan of action to secure immediate improvement. I want to be assured that the agreed actions represent the most effective interventions in respect of optimising unscheduled care.”
The Minister highlighted that primary and community care can often be just as important in solving the problem as the teams actually in the Emergency Departments. The most important thing is to make sure that patients get the care that is appropriate to their needs, and clinicians are supported in their efforts to provide that care. The Minister set out a range of areas he wanted examined to determine whether enough was currently being done, including:
- The level of consultant decision-making in Emergency Departments regarding discharge;
- Maximising the amount of surgery which can be done as day case rather than inpatient;
- Increasing the proportion of patients discharged each day who have left the ward by lunchtime;
- Sufficient ward rounds each day to promote early discharge;
- Only keeping the most seriously ill waiting on wards for investigations or procedures that could be done as an outpatient;
- Permitting senior nurses to discharge patients over weekends and public holidays;
- Actively tackling delays with discharges into the community;
- Developing options to deal with the 20-30% of patients who turn up inappropriately at Emergency Departments, such as triage nurses discharging individuals home and providing out of hours GP or Minor Injuries Unit on the same or an adjacent site.
The Minister also highlighted the importance of new arrangements: “The role of Integrated Care Partnerships as outlined in Transforming Your Care will be crucial in improving patient pathways and ensuring better collaboration between primary and hospital care. I will be requiring officials to ensure that work on the establishment of Integrated Care Partnerships is conducted as quickly as possible, so they can be rapidly introduced. They will play a key role in the broader reform programme”.
He concluded by saying: “I will continue to meet the HSCB Chief Executive and senior officials on a very regular basis to be assured progress is made and sustained.”