Issue - meetings

25.1     The Committee considered a report updating the HOSC on hospital handover delays at the Royal Sussex County Hospital (RSCH) and ongoing work between University Hospitals Sussex NHS Foundation Trust (UHSx) and South East Coast Ambulance NHS Foundation Trust (SECAmb) to reduce them.

25.2     The Committee asked whether it was a challenge working with three different social care authorities in discharging patients and ensuring patient flow.

25.3     Ali Robinson, UHSx Deputy Divisional Director of Operations, Medicine, said that it was a challenge working with three social care authorities, particularly at RSCH as it was the regional tertiary hospital. Proportionally there were more patients with No Criteria to Reside (NCtR) that were East Sussex residents. At RSCH there was a Transfer of Care Hub that worked across care providers and systems to match patient need as appropriate.

25.4     The Committee asked whether there would be a separate area in ED for patients with severe mental health issues.

25.5     Ali Robinson noted that this had been an area of sustained difficulty at the RSCH, and more recently UHSx had been working closely with SPFT to address estate issues. A section of the RSCH ED had been allocated to accommodate mental health patients, however this involved a trade-off with other physical health beds on the site which was another area of pressure. This area was staffed by a specific group of staff, separate from the main ED. The ICB was exploring whether there was scope to commission a specialist facility within Brighton & Hove that would ensure better support for patients in acute mental health crisis.

25.6     The Committee asked what learning had been taken from better performing hospital trusts with fewer delays.

25.7     Ali Robinson noted that UHSx and SECAmb had explored with a number of hospital sites about effective improvements and initiatives that had been implemented to reduce handover delays. The continuous flow model had been taken from another hospital.

25.8     The Committee asked what equipment ambulances carried to support patients with respiratory issues.

25.9     Paul Fisher responded that when an emergency call was received it would be triaged and SECAmb would aim to send the most appropriate resource. All ambulances carried oxygen and nebulisation was also available, although not all staff were authorised to deliver nebulised therapy. Critical care paramedics had advanced airway equipment and could attend emergency scenes as required, however in most circumstances a general response paramedic ambulance was able to support a patient with respiratory illness.

25.10   Cllr Turner requested follow up information on whether all emergency response ambulances carried CPAP equipment.

25.11   The Committee asked for clarification to whether the continuous flow model had gone live for the Surgical and Specialist divisions.

25.12   Ali Robinson confirmed that they had now gone live in the first week of December and had begun to have a marginal impact, with an expectation that they would further develop in time.

25.13   The Committee asked when the continuous flow model was expected to deliver an increase in total discharges.

25.14   Ali Robinson  ...  view the full minutes text for item 25

26.1     The Committee considered a report updating on hospital handover delays at the Royal Sussex County Hospital (RSCH) and ongoing work between University Hospitals Sussex NHS Foundation Trust (UHSx) and South East Coast Ambulance NHS Foundation Trust (SECAmb) to reduce them. Peter Lane, Hospital Director Royal Sussex County Hospital outlined that there are a number of short, medium and long term measures in place to reduce hospital handover times at the RSCH and patients are very rarely held in the back of ambulances. Paul Fisher, SECAmb Brighton Operating Unit Manager added that there was a lot of collaborative work to reduce hand over times and waits over 60 minutes, and it is hoped that benefit of this work will be seen in the next 6-12 months.

26.2     The Committee asked whether RSCH compared its handover times with other tertiary hospitals and if so, how it compared with them.

26.3     Alex Darling, Operations Manager at Brighton Make Ready Centre commented that SECAmb had data from 18 hospitals that it covered in the South East region, which included other trauma centres in the region and accepted a similar number of patients to the RSCH. When comparing data on handover delays the RSCH was almost always the hospital with the highest number of delays. Peter Lane commented that it was recognised that there was still more work to do to reduce handover times. Paul Fisher added that the challenges faced in reducing waiting times were recognised and both organisations work well together to deliver the best service that they can.

26.4     The Chair thanked both SECAmb and UHSx for all their hard work on this issue.

26.5     The Committee RESOLVED to note the report and receive an update report in 6 months time.