A combined medical and surgical assessment unit at the Friarage Hospital – which has reduced admissions to surgical wards by more than a third – has been shortlisted for a national award.
Since 2013, clinicians have been rapidly expanding their medical ambulatory care service which allows emergency patients, who would usually have to stay in hospital, to be treated as outpatients – or even in their own homes.
The unit, which is staffed by team of consultants, GP hospitalists and nurse practitioners, sees hundreds of patients every month who need urgent diagnostics and treatment for conditions as diverse as skin infection and liver failure but are not unwell enough to need an overnight stay in hospital (known as ambulatory care).
Since then they have also combined their service with OHPAT (outpatient and home parenteral antimicrobial therapy) and district-wide community nursing teams to provide care closer to home and, more recently, teamed up with surgical colleagues to create a combined medical and surgical assessment unit.
This has resulted in:
- A 34% reduction in non-elective admissions to the surgical ward
- A 46% increase in elective activity
- Accident and emergency performance being maintained at the Friarage Hospital
- Very high patient satisfaction with excellent feedback
Now, the unit has been shortlisted in the ‘acute service redesign’ category in the HSJ’s annual ‘Value in Healthcare Awards’ with the winners being announced in May 2017.
Consultant in infectious diseases Dr James Dunbar said: “We are a small rural hospital which means we often find solutions to problems by closer collaboration with our colleagues. Our ambition is to provide outstanding healthcare despite the challenges of serving such a rural population.
“By creating this combined unit, essentially what we’ve done is streamlined the assessment process for patients, allowing them to receive the correct treatment they need far quicker, often without the need for admission.
“The team are providing excellent same-day emergency care for the benefit of hundreds of patients and it means more surgical and medical beds are now available for people who really need to be in a hospital bed. The key to its success is early access to senior decision makers in the hospital.”
Alastair McLellan, HSJ Editor, said, “2017 is the year the NHS’s drive to improve the cost-effectiveness of its care moves from an important to a crucial factor in the service’s success. The entries to HSJ’s annual Value in Healthcare Awards provide plentiful evidence that all sectors of the NHS have recognised this and responded appropriately.
For the NHS to be affordable it must operate in a sustainable manner. The HSJ Value in Healthcare Awards show how hard the service is working to make that a reality.”
The model the Friarage team has developed is now being adopted at The James Cook University Hospital.
Gill Collinson, Chief Nurse of NHS Hambleton, Richmondshire and Whitby Clinical Commissioning Group (the CCG) said: “As commissioners, the CCG is delighted that the team at the Friarage Hospital have been shortlisted for this award. We have worked with and supported Dr Dunbar and the team over the past few years to make their vision a reality, so it’s great to see all their efforts recognised in this way.”
The Friends of the Friarage Hospital were hugely influential in getting the ambulatory unit, which was officially opened by Richmond MP Rishi Sunak, up and running, donating £42,000 towards an ECG machine, beds, pumps, trollies and furniture.
Chairman Upendra Somasundram said: “It’s great news that such an excellent service for patients has been shortlisted for this national award. The Friends are delighted to be able to continue to support this important clinical development at the Friarage Hospital.”