Gwent health board's drive to cut A&E waiting times

Gwetn health board's drive to cut A&E waiting times

Gwetn health board's drive to cut A&E waiting times

First published in News
Last updated

HEALTH bosses in Gwent have declared the ambitious aim of achieving a key – and elusive – waiting times target inside the next two years.

A minimum of 95 per cent of people attending emergency departments in Wales should be dealt with inside four hours, but in Gwent as in the rest of Wales, this has proved beyond health boards for several years.

Only at individual hospitals on irregular occasions has the 95 per cent target been met, while in recent times the numbers of patients waiting more than eight and 12 hours to be dealt with have grown.

Performance against the four-hour target has improved very gradually during the past two years, with Aneurin Bevan University Health Board forecasting that by the end of March and the current 2013/14 cycle, 92.3 per cent of emergency department attenders will have been dealt with inside four hours.

The aim is to increase that to 94 per cent by the end of 2014/15, and achieving and sustaining the target during 2015/16 and beyond.

This however, must be done against a backdrop of rising attendances. Last year almost 164,000 people attended emergency departments in Gwent – primarily A&E at the Royal Gwent and Nevill Hall Hospitals, but also the emergency unit at Ysbyty Ystrad Fawr at Ystrad Mynach – and this year that forecast to climb to close to 174,500, an increase of more than six per cent.

The health board’s focus is on developing a sustainable mix of emergency staff, not least working toward boosting the level of consultant and senior doctor cover at the ‘front door’, seven days a week.

Investment has also been made in advanced clinical practitioner posts and the development of clinical decisions units to quicken assessments and decisions on admission or discharge for patients.

Emergency departments are also dealing with more elderly and complex patients, and in Gwent a Frail Older Persons Assessment and Liaison (Fopal) team has been created to improve the journey through the hospital system for these patients.

Another key part of the health board’s plan is to cut waits of more than 12 hours in emergency departments.

Two thousand patients are likely to have waited longer than 12 hours in Gwent emergency departments during 2013/14. The aim is to halve that figure next year, reducing to 500 during 2015/16, and zero during 2016/17.

Comments (6)

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2:30pm Wed 19 Feb 14

kenny john says...

Simple, get the gp service working correctly, use and resource localised minor injury facilities and cut duplication in paperwork. Additionally educate the public and realise Gwent is a community with issues, from both a health and social perspective.Work with communities, not issuing figures and targets from an Ivory tower.
Simple, get the gp service working correctly, use and resource localised minor injury facilities and cut duplication in paperwork. Additionally educate the public and realise Gwent is a community with issues, from both a health and social perspective.Work with communities, not issuing figures and targets from an Ivory tower. kenny john
  • Score: 0

3:02am Thu 20 Feb 14

Angrybirdie says...

My husband (age46) has been sent to the Medical Assessment unit this evening by his GP in Caldicot for blood tests following complaints of a tight chest & dull ache in his arm. An ECG was carried out in his local surgery with normal results. We arrived at 7.15pm at the RGH Medical Assessment unit & gave the letter from his GP requesting a routine blood test. His GP had attached the ECG print out together with a brief health history, blood pressure reading for that evening & a recent normal cholesteral & diabetes test which had been taken this week (as my husband has annual checks which he takes upon himself to have done). There were approx. 8 other patients with their families in the waiting area. 6 of which were in the process on being seen, then my husband & 1 other after him. As we sat down, a lady came out of the assessment ward with her husband wishing everyone in the waiting area good health & good luck as she had been sent to the MAU at 11am that morning & was just leaving at 7.30pm. At this point, I thought that surely we would not be that long! At 8.30pm my husband was seen by a nurse, who took his blood pressure, ECG, bloods, & blood sugar level, which, apart from the blood test came back normal. The bloods would take 2-3 hours for the results to come back then he would have to be seen by the doctor. The nurse advised at this point, at 8.45pm, that there would be a shift change of doctor's at 9.30pm but that the 5 that were on the MAU would be reduced to 2, so we might be in for a long wait & would definitely have to wait the 2-3 hrs for the blood results & that even though she was qualified to say if results were normal she would not be able to let him home until he was seen by a ward doctor & he was now in 13th place to see the Doc assuming that the blood results were back. At this point I had to make a reluctant decision to leave the hospital, as my 2 boys were at home with a babysitter that I had to get at short notice. I got home at 9.20pm. My husband had his blood results back at 10.30pm the nurse said they were normal. At 1am I phoned the MAU to find out what was happening as I am still sick with worry & unable to contact my husband as no mobile signal available in that unit. A staff member put him on the phone, he was the only one sat in the waiting area, waiting to be seen by a doctor! The time now is 2.15am my husband has just phoned me. He is now second to see a doctor as the doctor is also covering another ward! Why does it take this long? Why can't decision be made earlier? Obviously there is a shortage of doctors at this hospital. If my husband hasn't had a heart attack, which clearly the nursing staff have the experience to know how to deal with this, why keep him there waiting. Why can't the patient's who can be dealt with quickly be seen & sent on their way. My son has now woke up, worrying because his Dad is not home. If they send him home now, he is likely to have a road traffic accident, driving home & falling asleep at the wheel & ending back in the A&E Dept. What a crazy system! If the bloods were taken on arrival at 7.15pm the results would have been back sooner & he would have stood a better chance of seeing 1 of the 5 doctors that were on that ward before 9.30pm. It is now 2.50am, and still no news. I give up hope with the NHS. Perhaps we should have gone to Neville Hall Hospital in Abergavenny.
My husband (age46) has been sent to the Medical Assessment unit this evening by his GP in Caldicot for blood tests following complaints of a tight chest & dull ache in his arm. An ECG was carried out in his local surgery with normal results. We arrived at 7.15pm at the RGH Medical Assessment unit & gave the letter from his GP requesting a routine blood test. His GP had attached the ECG print out together with a brief health history, blood pressure reading for that evening & a recent normal cholesteral & diabetes test which had been taken this week (as my husband has annual checks which he takes upon himself to have done). There were approx. 8 other patients with their families in the waiting area. 6 of which were in the process on being seen, then my husband & 1 other after him. As we sat down, a lady came out of the assessment ward with her husband wishing everyone in the waiting area good health & good luck as she had been sent to the MAU at 11am that morning & was just leaving at 7.30pm. At this point, I thought that surely we would not be that long! At 8.30pm my husband was seen by a nurse, who took his blood pressure, ECG, bloods, & blood sugar level, which, apart from the blood test came back normal. The bloods would take 2-3 hours for the results to come back then he would have to be seen by the doctor. The nurse advised at this point, at 8.45pm, that there would be a shift change of doctor's at 9.30pm but that the 5 that were on the MAU would be reduced to 2, so we might be in for a long wait & would definitely have to wait the 2-3 hrs for the blood results & that even though she was qualified to say if results were normal she would not be able to let him home until he was seen by a ward doctor & he was now in 13th place to see the Doc assuming that the blood results were back. At this point I had to make a reluctant decision to leave the hospital, as my 2 boys were at home with a babysitter that I had to get at short notice. I got home at 9.20pm. My husband had his blood results back at 10.30pm the nurse said they were normal. At 1am I phoned the MAU to find out what was happening as I am still sick with worry & unable to contact my husband as no mobile signal available in that unit. A staff member put him on the phone, he was the only one sat in the waiting area, waiting to be seen by a doctor! The time now is 2.15am my husband has just phoned me. He is now second to see a doctor as the doctor is also covering another ward! Why does it take this long? Why can't decision be made earlier? Obviously there is a shortage of doctors at this hospital. If my husband hasn't had a heart attack, which clearly the nursing staff have the experience to know how to deal with this, why keep him there waiting. Why can't the patient's who can be dealt with quickly be seen & sent on their way. My son has now woke up, worrying because his Dad is not home. If they send him home now, he is likely to have a road traffic accident, driving home & falling asleep at the wheel & ending back in the A&E Dept. What a crazy system! If the bloods were taken on arrival at 7.15pm the results would have been back sooner & he would have stood a better chance of seeing 1 of the 5 doctors that were on that ward before 9.30pm. It is now 2.50am, and still no news. I give up hope with the NHS. Perhaps we should have gone to Neville Hall Hospital in Abergavenny. Angrybirdie
  • Score: 0

3:04am Thu 20 Feb 14

Angrybirdie says...

Still no news. I hope the Health Board bosses contact me.
Still no news. I hope the Health Board bosses contact me. Angrybirdie
  • Score: 0

6:57am Thu 20 Feb 14

Angrybirdie says...

Unbelievable! He just got home. Let out at 6am 11 hours later. He didn't have a heart attack(well we guessed that). Probably muscular. He had to have an XRay, which took another 40 minutes, before they would let him out. The Doctor did apologise for the wait but said it's the norm in here.

I'm happy I have my husband home & grateful to the staff for the care they provide under such terrible working conditions. They only try to do the job they trained hard for and love most of the time.

I feel sick now been up with worry all night phoned the hospital half a dozen times to see what's happening. My blood pressure peaked at 150/94. (I have a monitor at home) but I'm not going any where near a doctor's surgery or hospital. I'd rather see a vet!
My kids won't be going to school today they couldn't sleep either and their parents are knackered. So if Monmouthshire County Council want to fine us over that, so be it. Funnily enough, my year 6 son, has a First Aid Course to attend today in school, which I had to pay £3 per pupil for so I will stay up now and send him to school. There's something not right with that either. But that's another rant.
Unbelievable! He just got home. Let out at 6am 11 hours later. He didn't have a heart attack(well we guessed that). Probably muscular. He had to have an XRay, which took another 40 minutes, before they would let him out. The Doctor did apologise for the wait but said it's the norm in here. I'm happy I have my husband home & grateful to the staff for the care they provide under such terrible working conditions. They only try to do the job they trained hard for and love most of the time. I feel sick now been up with worry all night phoned the hospital half a dozen times to see what's happening. My blood pressure peaked at 150/94. (I have a monitor at home) but I'm not going any where near a doctor's surgery or hospital. I'd rather see a vet! My kids won't be going to school today they couldn't sleep either and their parents are knackered. So if Monmouthshire County Council want to fine us over that, so be it. Funnily enough, my year 6 son, has a First Aid Course to attend today in school, which I had to pay £3 per pupil for so I will stay up now and send him to school. There's something not right with that either. But that's another rant. Angrybirdie
  • Score: 0

7:14am Thu 20 Feb 14

Angrybirdie says...

Just to add to the above. I think a 21st century hospital with more staff & ample parking would better serve the City of Newport & surrounding Counties, at the old Llanwern Steelworks Site rather than more housing. Why wasn't that on the Unitary Development Plan. The Health Board Bosses need to wake up and smell the coffee! I hope they contact me.
Just to add to the above. I think a 21st century hospital with more staff & ample parking would better serve the City of Newport & surrounding Counties, at the old Llanwern Steelworks Site rather than more housing. Why wasn't that on the Unitary Development Plan. The Health Board Bosses need to wake up and smell the coffee! I hope they contact me. Angrybirdie
  • Score: 0

10:27pm Thu 20 Feb 14

kenny john says...

The position of a major trauma hospital at Lanwern is the wrong location. They have the correct location planned for the SCCC, however with constant cost cutting, by the time it opens it will be of a far lower build standard than originally planned, with confusing service provision, an inadequate staff provision and disorganised ambulance service that is not fit for purpose. Still I bet it will have a delightful entrance with a WH Smith and Starbucks in the foyer!!!
The position of a major trauma hospital at Lanwern is the wrong location. They have the correct location planned for the SCCC, however with constant cost cutting, by the time it opens it will be of a far lower build standard than originally planned, with confusing service provision, an inadequate staff provision and disorganised ambulance service that is not fit for purpose. Still I bet it will have a delightful entrance with a WH Smith and Starbucks in the foyer!!! kenny john
  • Score: 0

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