New units could ease pressure at Nevill Hall and Royal Gwent Hospitals
NEW units could be created at the Royal Gwent and Nevill Hall Hospitals, where patients awaiting test results or some treatments can be cared for without the need for admission as inpatients.
Clinical Decision Units (CDUs) are being developed at several acute hospitals across the UK, as a means of helping ease the pressure on increasingly busy A&E departments.
Aneurin Bevan Health Board is making a bid for an unspecified share of a £10 million Wales-wide fund to support emergency care, announced in the summer by health minister Lesley Griffiths, to fund the units.
The role of the CDUs in Gwent would be predominantly to take in appropriate medical patients coming through A&E.
Increases in acute care physicians, particularly at the Royal Gwent, has enabled them on occasion to take selected patients from A&E and deal with them directly, rather than these patients having to pass through the A&E system beforehand.
A CDU would allow this process to be formalised, enabling patients who obviously need to be seen by acute medical specialists to be sent directly to the unit, which would be run by an acute care physician.
The health board is also looking at other measures designed to keep out of A&E patients who do not need to be there.
These include a clinical call handling system for GP calls, in which Gwent Frailty Programme staff would handle calls from GPs requesting patient assessments and admission.
A pilot scheme last year resulted in seven patients a day, primarily elderly, being redirected to the frailty service and receiving enhanced care in their home, rather than having to go into hospital. The aim now is to create a 24/7 clinical GP call handling system.
Another proposed measure is a discharge team for patients with non-acute but complex needs.
At any one time in Gwent hospitals, 40-60 medically fit patients are in acute beds awaiting discharge. The aim would be to speed up patients' discharge or transfer home, or to a nursing home placement or community hospital bed.