Annual Report and Accounts 2012/13 - Royal Bournemouth Hospital

Business Reviewl additional medical support - increasedresources to provide more supportand consultant time; available at thefront door and to look after elderlypatients with surgical problemsl a greater focus on improving thedischarge process and reducingre-admissions. To support reductionsin length of stay, commissioners andsocial services agreed to support‘out of hospital assessments’for community hospital (CHC)assessments. This enables patientsto leave hospital much earlier in theprocessl a joint initiative between socialservices and the OPAL team to enablepatients to be fast-tracked home,with reablement support, continuedthroughout the winterl increased staffing into the dischargecoordination team to provide a sevenday service, eradicating some delaysand reducing length of staysl increased support into the clinical siteteam. An additional full time Band 6nurse for the clinical site team wasappointed over the winter period toenhance the resilience of the team andensure a hospital at night contact isavailable over the entire weekend. Thisalso supported junior doctors withtheir workloadl a housekeeping ‘SWAT’ team wasintroduced to deal with deep andterminal cleans in a timely mannerl additional portering specificallybetween Emergency Department andX-rayl specific directorate support, includinga dementia nurse specialist, pharmacysupport in acute medical unit andadditional therapy staffl increased presence of primary care(GPs) in the Emergency DepartmentThe Trust is very reliant on other partnerorganisations that provide services suchas intermediate care and social care tobe responsive and meet the needs ofpatients in a timely way. Weeklycross-organisational teleconferenceswere held to help promote and agreeearly solutions to the significant issuesfaced.Health groups gathered foremergency pressure talksKey health and social care groupscame together in February and Marchfor executive level talks to discussemergency pressures and the long term,quality of care for patients.Representatives from primary care,secondary care, community care,commissioners and the ambulanceservice met to decide what needs to bedone to make a significant difference forpatients in the right place in the system.Twelve key action points were developedfrom the meeting which were agreed byall healthcare chief executives acrossDorset. For example, what changes needto be made in caring for the frail, elderlyand those with dementia to ensure abetter system for the patients and theirfamilies and carers. An overarchingsteering board led by GPs has also beenintroduced to oversee progress and toensure proposals are implemented.Helen Lingham, Chief Operating Officerat RBCH, said: “We had an excellentdiscussion around what needs changingin the system to better support theemergency and urgent care needs of ourpopulation.“There was a clear acknowledgement thatwe have to manage the system differentlyin order to retain high quality care underincreasing demand.“The only way we will succeed is byagreeing joint responsibility for thechallenges. The steering board will alsoensure we do what we say we need todo.”28Annual Report and Accounts 2012/13