A&E success

THINGS are looking up for Ipswich Hospital's accident and emergency department.At the start of winter it was having to turn away ambulances and set up waiting areas in the fracture clinic, but thanks to the opening of a new Acute Medical Unit all that has changed.

THINGS are looking up for Ipswich Hospital's accident and emergency department.

At the start of winter it was having to turn away ambulances and set up waiting areas in the fracture clinic, but thanks to the opening of a new Acute Medical Unit all that has changed.

Today waiting times are down, staff are under less pressure, and patients' journeys through the hospital are quicker and more efficient. SARAH GILLETT went to find out more about the recovery plan.

AS the first port of call for the majority of patients entering Ipswich Hospital, the accident and emergency department is a hustle and bustle of activity.

Even when the waiting room appears relatively quiet, there is a wealth of work being done on the other side of the doors.

Doctors and nurses work side by side to deliver treatment in a number of bays, all of which are surrounded by the bright blue disposal curtains introduced to the hospital this autumn. On average they will see between 100-120 patients a day.

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From time to time, a red phone on the wall by the nurse station rings to forewarn of any incoming emergencies, such as a road accident, that will need a team of staff to be on hand when the ambulance arrives.

And despite the obstacles placed in its way - like ward closures and rising numbers of emergency admissions to name but a few - the picture behind the doors has remained the same; a dedicated band of staff continuing to provide a first class service to patients.

For them it has been a trying, sometimes extremely difficult, time but they have come through it and are now seeing their hard work rewarded by falling A&E waiting times.

Government targets state that patients should be seen within four hours of entering A&E, and it is from this figure that statistics are used to map how well the department is doing.

However, the staff are keen to stress that, while the latest figures are a boost to morale, what is most important is that patients receive all the care and attention they need.

Sister Deborah Orchard of the A&E department, said: “The fact that we are starting to meet targets has really boosted staff morale but what is really important to us is that we provide the right care for patients.

“Obviously, we do try to help meet the targets but we would never compromise patient care to do it.”

The biggest challenge facing staff in the department is a continually rising number of people needing emergency treatment.

On average around 52,000 people will pass through the doors of the department each year, but last year the figure rose to nearly 56,000.

Mrs Orchard said: “It has been really hard work for about the last 18 months or so, the place has just been full all the time.

“Traditionally in A&E you get a kind of lull in the summer but we haven't had that this year.

“Fortunately, we've got a really good team and everyone has really supported each other.

“We all appreciate the pressures everyone has been under and we've done our best to work together.”

One of the biggest boosts to A&E in recent months has been the introduction of emergency nurse practitioners - specially-trained nurses who can deal with problems that patients would usually have to wait to see a doctor for.

Louise Lloyd, one of the new practitioners, runs a minor injuries clinic at A&E.

She said: “Patients can come in and see a qualified nurse who has experience in A&E. It can be anything from ankle sprains to cuts requiring stitches.

“They are still given the option of seeing a doctor if they wish but the wait may be longer.

“It helps us to get people through A&E a lot quicker.”

The biggest factor in the reduction in waiting times is the hospital's new state of the art Acute Medical Unit.

Opened at the end of November, the £1.2 million unit offers an alternative way of assessing and treating patients which has helped to significantly free up staff in A&E.

The unit works by taking people with urgent medical conditions away from the department. People can be referred straight there by their GP instead of having to wait in A&E and, once there, they will be seen by a senior clinician within two hours who can assess where is the most appropriate place for them to be treated.

Before the opening of the unit, this could take up to 12 hours causing delays in other areas of the hospital.

Mrs Orchard said: “The opening of AMU has definitely had a huge impact on the department. We are still treating large quantities of minor injuries but the majority of medical patients are going straight to AMU and on to the appropriate places.”

Ms Lloyd, who has been working in A&E at Ipswich for two years, said: “This is definitely one of the busiest departments I have worked in, but it is a very good department and the difference the AMU has made has been fabulous.

“Because we got so used to it being really busy we are all in a kind of sense of shock at the moment I think!

“We are able to look after patients much better because we are not so pressurised. They are getting much better care now because we've got more time.”

Heading up the new unit is senior consultant Dr Nicky Trepte. Her presence in the unit means that patients get faster access to the right place for treatment, rather than having to wait to be assessed by a doctor on his or her ward rounds.

She said: “So far it is working very well. It's been very busy but our figures are already showing that people are getting scans and investigations done promptly and the turnaround time for the unit is under eight hours.

“I have had fantastic support from my colleagues and I can get about five or six patients out before 5pm each evening, be that home or to another more appropriate ward in the hospital.

“It does seem to be having a big impact on the A&E department too.”

A big part of Dr Trepte's role is ensuring patients are in the most appropriate place. Through thorough assessments she can work out where they need to be and set the wheels in motion to get them there.

She said: “The right patients are now getting the right treatment in the right beds.

“We can filter patients appropriately; get them home if we can or get them extra support if we can.”

The hospital is currently advertising for two more consultants to work in the unit alongside Dr Trepte.

Ruth Hart, a sister on the AMU, said: “We are finding it a much nicer environment to work in and it is much better for the patients because we are getting them seen and sorted much quicker.”

What have your experiences of A&E and the AMU been like? Write to Your Letters, Evening Star, 30 Lower Brook Street, Ipswich, IP4 1AN or send us an e-mail to eveningstarletters@eveningstar.co.uk

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