Almost 20,000 patients turning up at Blackpool’s over-crowded casualty with minor injuries will be funnelled through a new service.
The extended Urgent Care Centre ward, will be manned by GPs and nurses, and will care for patients whose injuries are not serious enough for A&E, similar to the Walk-in Centre in Whitegate Drive.
A new mental health ward will also be built so people in crises aren’t left languishing in cubicles elsewhere, while a new discharge lounge will stop those waiting to go home taking up beds.
The children’s waiting area will be moved, an ambulance handover room will be created, and triage will be overhauled so treatment is started earlier, hospital bosses said.
Some £2m will be spent, with work set to be finished as early as Monday, October 2, in time for the busiest time of the year for medics.
Simon Tucker, who runs Blackpool Victoria Hospital’s emergency department, exclusively told The Gazette: “It’s like Game of Thrones – winter is coming. We want this in place so when winter comes, we have the resources in place.
This winter could be even harder than last winter, and we really, really struggled last winter.
“What it should mean is the emergency department is better protected to look after the really poorly, critically-ill patients.”
Blackpool’s emergency department, like many across the county, is often over-crowded and, usually, winter is far worse.
But this year, staff have been left battle-weary by an unrelenting number of patients. In fact, bosses haven’t noted any dip during the summer months, with medics as busy as ever.
And Simon, who heads up Blackpool’s casualty, said: “This winter could be even harder than last winter, and we really, really struggled last winter.”
By making changes, patients should be seen, treated, and discharged quicker, and seen by more appropriate doctors in the right departments faster.
‘URGENT CARE CENTRE PLUS’
Fylde Coast Medical Services, the not-for-profit group that runs the Urgent Care Centre, as well as the Walk-in Centre, will now also see patients with minor injuries, rather than doctors in A&E, as well as less serious illnesses.
Only people with certain conditions – wounds and minor limb injuries – will be seen at first, but a total of 18,000 out of the 89,000 turning up to A&E every year will soon be treated there, leaving A&E free for the most serious cases.
“We are getting a lot of emergencies now. We are seeing patients who are sicker, who are requiring more intervention, and are more challenging, and those will always be our priority,” Mr Tucker, who described the new service as the ‘Urgent Care Centre plus’, said.
“If we don’t see them first, those are going to be the ones that become very unwell.”
The move should reduce delays by ending the practice of leaving the least poorly people waiting in A&E in treatment, Mr Tucker explained.
He added: “Instead of joining a very long queue because of all the really sick patients coming through, they are actually going to the GP-led Urgent Care Centre side, where the advanced nurse practitioners, who are specifically trained in the management of minor injuries, will be able to look after them.
“They are going to get a much faster service, a more efficient service, but certainly not to any extent a poorer or less of a service. It’ll be as good as, if not better.
“It’ll work very much in the same way [as the Walk-in Centre]. The systems in place there are probably the same systems they will put in place here.”
New dedicated mental health ward
Hospital bosses have worked with Lancashire Care, the trust responsible for mental health care across the county, to develop a dedicated mental health ward.
Last year, more people arrived at Blackpool’s A&E suffering from a mental health crisis than at any other hospital in the country, with patients left waiting for hours to be seen in what can be a distressing environment.
Mr Tucker said: “Mental health is a big demand. We get a lot of patients who need mental health assistance, and I think it’s fair to say that process is quite prolonged.
“What we want to do is give them the correct environment so when they are waiting for everything to happen, it’s less stressful for them, and it improves efficiency.
“We’ve always said mental health patients could get a better service with the right resource, and this is a project that has been looked at for quite some time.
“For that group of individuals, all the building work and proposals is really positive, and a good move.”
Lancashire Care said the unit will not have any beds, but will be able to help four over-18s at any one time.
“The service will be delivered in partnership with a [charity] who can support recovery alongside specialist mental health practitioners,” it said in a statement.
“The planned unit will provide a more appropriate, short term safe therapeutic environment away from the A&E department where people in crisis can be assessed, offered a brief intervention and then referred to the appropriate service, or be supported back into the community.
“The unit will be a 24/7 facility that provides an alternative pathway for people requiring urgent mental health on-going assessment and suffering with mental health difficulties in crisis.”
What are others saying?
Pat Oliver, the hospital’s director of operations, said: “Like most health economies, we have experienced pressures across the system and struggled to achieve the four-hour target recently.
“The pressures have highlighted a number of areas where improvement is essential to provide high quality care to all patients.
“We have experienced delays in patient care and we want to improve the privacy and dignity of care in the area, but we are hindered as some parts of the current facility are outdated and in need of modernisation.
“An increase in the transfer of minor injuries will immediately result in a reduction in time to be seen for this group of patients, as they will no longer be competing with the ‘major’ patients who require immediate attention from the emergency department specialist.”
Medical director Prof Mark O’Donnell added: “The aim of these changes is to make significant improvements in the quality and performance of the care we give through a modernisation of the Urgent Care facilities.
“This is an exciting but challenging transformation programme which will enhance the patient experience by ensuring they are seen in a timely manner in the most appropriate setting.”
What else is changing?
The current children’s area will become part of the adult assessment area, which will get more cubicles as a result.
This means staff will be able to ‘keep a closer eye on the sickest patients’, Mr Tucker said.
And nearby, patients arriving by ambulance will be taken into a newly-created handover room to be placed on a hospital stretcher in a more private setting, rather than it being done in a corridor.
A ‘discharge lounge’ will also be set up, where patients can wait for final checks and paperwork to be done before leaving hospital.
Currently, they would have to wait in bed – causing backlogs all the way back to A&E.
An overhaul of the triage system should also mean patients can be treated sooner, the hospital said.
Rather than a quick check in one of two cubicles before being given a red, amber, or green classification, a more in-depth examination will be carried out by a senior nurse or doctor in one of six cubicles.
A target of 15 minutes will apply and, because of the in-depth exam, treatment should start faster than ever before.
Children’s assessment area will be secure and easier to get to
The children’s assessment area will be moved closer to the department’s entrance to address concerns over its current location.
The new dedicated waiting area will be secured by key fobs and will mean children and their parents don’t have to walk through the adult assessment area, which, especially late at night on weekends, can be a ‘distressing’ place for youngsters, Mr Tucker said.
“We have a beautiful and very efficient paediatrics area,” he added.
“But one of the criticisms from the Care Quality Commission and from patients was to get access you have to walk through the adult area, where there’s lots of poorly people.
“Is that appropriate? It that distressing? Actually, we said it’s not right.”