HEALTH OVERVIEW AND SCRUTINY COMMITTEE

03 March 2022

South East Coast Ambulance Service Hospital handover Update

Report from:         Emma Williams, Executive Director of Operations, SECAmb

Author:                  Ray Savage, Strategic Partnerships Manager (SECAmb)

1.1. The NHS Long Term Plan sets out as one if its priorities, a reduction in ambulance handover delays. The aim is to have a ‘zero’ tolerance towards any greater than 60-minute handover delays and a focus on returning to the national standard of all patient handover within 15 minutes.

1.2. The NHS Emergency Care Improvement Support Team (ECIST) are a clinically led national team that provide support to ‘systems’ in achieving the delivery of high-quality emergency care.  

1.3. ECIST have been proactively working with the Royal Sussex County Hospital in Brighton, where handover delays, at times, have been significant.

1.4. Each month, at the National Ambulance Handover meeting – chaired by Anthony Marsh (CEO of West Midlands Association of Ambulance Service/Chair of the Association of Ambulance Chief Executives (AACE)), supported by NHS England/Improvement, and commissioners, the areas that have the greatest challenges with patient handovers are discussed. ECIT also give feedback to the hospitals they have visited and supported.

1.5. Also in November, AACE published a report titled “Delayed hospital handovers: Impact assessment of patient harm”, having collated hospital handover data from all 10 ambulance services, including SECAmb.

1.6. The report focuses on a single day in January 2021 and the overarching conclusion is that 8 out of 10 patients who have to wait greater than 60 minutes are at risk of harm and the study highlighting that 53% did experience some level of harm.  

1.7. Within Sussex, the Integrated Care System (ICS) has the reduction of ‘handovers’ as a key priority for its Urgent and Emergency Care (UEC) programme and emphasises its ‘zero’ tolerance for any handover greater than 60 minutes, in addition to reducing handover delays greater than 15 minutes.

1.8. At an East Sussex level, the Local Accident and Emergency Delivery Board monitors handover delays at both hospitals (Eastbourne District General Hospital (EDGH) & Conquest Hospital) and reporting on delays is a key part of the Urgent and Emergency Care dashboard.

1.9. Handover delays at East Sussex Healthcare NHS Trust (ESHT) greater than 60 minutes have not only been reflective of the bed occupancy within the trust (flow), but also a reflection of the pressure within the wider system.  

1.10. The SECAmb operational team have worked collaboratively with ESHT’s emergency department team to improve the process for patient handover and the number of delays reported for January 2022, at 25 greater than 60 minutes, has been the lowest since July 2021, where there were 16 greater than 60 minutes. November 2021, by contrast, had 86 greater than 60 minutes. This reduction is indicative of the work that has been done, internally within ESHT and between the two trusts, including daily meetings to discuss improvements and support from SECAmb operational management team when delays start to happen.

1.11. Handover delays of greater than 60 minutes at neighbouring hospitals for January 2022 were:

· Royal Sussex County Hospital (RSCH) – 207 delays greater than 60 minutes;

· Pembury (Tunbridge Wells) – 7 delays greater than 60 minutes.

1.12. Further details of handover delays at ESHT, RSCH and Pembury are set out in Appendix A.

15.

Lead Officer Contact

Ray Savage, Strategic Partnerships Manager (SECAmb)

Appendix A - Hospital Handover Delays

Hospital Handover Delays at East Sussex Healthcare NHS Trust (ESHT) (Eastbourne DGH/Conquest Hospital), Date (01/01/2021 - 31/01/2022)

Hospital Handover Delays at the Royal Sussex County Hospital, Date (01/01/2021 - 31/01/2022)

Hospital Handover Delays at the Tunbridge Wells Hospital (Pembury), Date (01/01/2021 - 31/01/2022)