Managing emergency pressures this winter
It has long been acknowledged that the majority of people who turn up at A&E do not need to be seen or treated in an emergency department.
What’s less well-known is how successful our hospitals are becoming in streaming them to a more appropriate healthcare setting, like an Urgent Treatment Centre.
The Royal London has the best record for this in the capital, according to a recent regional audit, and Newham is not far behind. Whipps Cross is on a par with our neighbouring providers at Homerton and Queens hospitals, about average for the 27 A&E units in London.
The audit shows there is still more to do, including for the 25% per cent of Royal London patients (and 29% at Newham) who were seen in ED but didn’t need to be. So as part of our preparations for winter, all three hospitals in our group are working together to further improve flow and relieve the pressure on their respective A&E.
We are supporting them with our campaign urging patients to #RethinkA&E and consider going to a GP or pharmacy instead, in line with the Finding the Right NHS Care messages of our local healthcare partners.
We continue to report the highest number of A&E attendances in London, with over 50,000 people presenting in October, about 3,000 more than a year ago.
This sets a new record for us, although a silver lining is that almost 6,000 of these were those that can be seen promptly through Same Day Emergency Care (SDEC).
We are further expanding our SDEC facilities, with a set of new chairs installed at Newham and extra capacity planned at Whipps Cross.
Unfortunately, SDEC patients are not yet counted in the official statistics that show we see seven out of ten EDC attendees within the national four-hour standard, while one in ten spend over 12 hours there.
The Royal London receives 40% of our urgent emergency attendances, with Whipps and Newham receiving 30% each. About 10% require hospital admission overnight.
We are also working with our partners to establish alternative pathways for patients with mental health issues who don’t need to be in ED, while offering enhanced support through specialist nurses for those who do.
Chris Pocklington, director of group operations, said: “This winter is going to be difficult and we will be extremely busy. However we are steadily improving and taking further steps to build resilience across the group.
“Malik Ramadan, medical director for The Royal London, is providing expert support across the group as interim clinical lead to help find ways to get patients to the right treatment as soon as we can and reduce waits.”