REACH for medical advice to reduce unnecessary hospital visits
Thousands of people will avoid long waits in A&E this winter through a pioneering scheme to provide the right emergency treatment in the right place, first time.
Trials in east London have shown that many people who call 999 do not need to go to A&E, but can be successfully treated in other ways to meet their care needs.
New arrangements agreed by the Barts Health NHS Trust, London Ambulance Service, NHS 111 and NEL CCG aim to reduce unnecessary hospital visits by facilitating other appropriate care pathways.
Ambulance crews can now call The Royal London Hospital A&E directly to get expert clinical advice for the patients they are seeing.
Appropriate care pathways include virtual consultations with a senior doctor, appointments in hot clinics, or sending rapid response teams to see patients in their own homes.
This specialist service staffed 12 hours a day by emergency medicine consultants is also available to NHS 111, so patients can be offered virtual consultations on the most appropriate emergency care instead of going to A&E.
A pilot of the Remote Access Emergency Coordination Hub (REACH) won a prestigious Health Services Journal award, and is being relaunched to serve Whipps Cross and Newham University Hospitals as well.
REACH will also offer clinical support to community teams and other providers seeking unscheduled care for their patients, so patients can access the full range of acute secondary services.
Clinicians have advised that in a full year a substantial number of people could be offered more appropriate treatment than having to attend A&E. Patient feedback from the pilot was positive, and service data showed care is safe and effective.
The service also helps ensure that the sickest patients with emergency problems are able to access timely hospital treatment without delay.
Dr Tony Joy, emergency medicine and pre-hospital care consultant, said:
“Virtual consultations in an emergency setting are very effective at treating patients without them needing to attend hospital. Our innovative, integrated and patient-centred model of care is able to reduce the number of patients attending by ambulance or walking-in, and offers the potential to transform the delivery of emergency care on a wider scale.”
Clinicians at Barts Health and LAS are working closely with primary care and Rapid Response Team colleagues at both Homerton University Hospital and Barking, Havering and Redbridge Hospitals, with the vision of extending the REACH service across all of North East London.