Hospital unit aims to send patients home

ARRIVING at hospital in an emergency can be a terrifying time. The Acute Medical Unit at Ipswich Hospital aims to ease the process by giving you a decision on your treatment within hours.

ARRIVING at hospital in an emergency can be a terrifying time. The Acute Medical Unit at Ipswich Hospital aims to ease the process by giving you a decision on your treatment within hours. In the latest of our behind-the-scenes features at the hospital, SARAH GILLETT went to find out more.

WE have all heard the tales of long waits in Ipswich Hospital's Accident and Emergency department, and of ambulances unable to unload their patients because there was nowhere for them to go.

But in the last 18 months things have drastically improved, and today the hospital is seeing 98 per cent of patients within four hours and meeting all government targets.

Much of this success is down to the work of one particular department - the Acute Medical Unit (AMU). Opened in November 2004, the unit improves the flow of patients through the hospital and ensures that people who are admitted with medical conditions (things like strokes, blood clots and asthma attacks that do not need surgery) have fast access to the expertise of a senior doctor.

Patients can be sent to the unit from A&E, directly from GPs or from outpatients clinics within the hospital and, once there, will be assessed and monitored while doctors decide what the next move should be.

Dr Monica Bose, one of the unit's three consultants, said: “We aim to provide a welcoming front door to the hospital. Patients are sometimes very ill and have a lot to go through but the unit means they can be dealt with promptly and be appropriately directed in the right way.”

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Initially, the unit had one dedicated consultant Dr Nicky Trepte, but has since employed two more, Dr Bose and Dr Rob Mallinson, alongside two registrars.

This means patients no longer have to wait around for the on-call doctor to arrive, and the team pride themselves on the speed at which they are able to treat patients.

Sarah Wales, a DVT nurse said: “The assessment unit used to have an on-call team of doctors but patients could end up waiting some time to see them, which inevitably ended up with people stacked up in A&E. This unit has made an absolutely huge difference to this.”

Helen Prodger, senior registered nurse, agreed: “People will initially be seen by a nurse but they should be seen by a doctor within half an hour maximum.

“We a lot of very positive feedback from patients about the speed at which they are seen.”

The aim is that no patient will stay on the unit for more than 48 hours before they are either admitted in to a hospital ward for further treatment or sent home.

The unit, which sees around 35 new patients through its doors every day, is split in to three parts:

the Brantham Assessment Unit - where patients are assessed and visited by a consultant. The aim is that nobody stays in this part of the unit for more than four hours.

The Brantham Observation Unit - Patients who are deemed to need extra observation, but may not be ill enough to be admitted to a ward will stay here.

Capel ward - A short stay ward, where patients spend no longer than 48 hours.

The emphasis is on ensuring that no-one stays in hospital longer than is absolutely necessary, so the unit works closely with nursing staff out in the community to ensure that people will be closely monitored once they are discharged.

Consultant Dr Rob Mallinson said: “We are sending home a significant number of patients. 30pc of people that come in will go home rather than be admitted. We are able to engage with other services to provide alternative support packages at home for patients within the community.

“It's about bringing it all together, getting early senior opinions and getting management plans in place for people. Directing consultants towards the front door of the hospital is quite a bold move. I think this hospital has been very brave in going for it and equally bold in building this unit.

“Putting consultants down here has improved discharge procedures because concentrating all of your resources in one area is just much more efficient.”

The unit also works very closely with the hospital's physiotherapy and occupational therapy teams, helping to ensure patients are fit enough to go home.

Kathyrn Rice, a senior occupational therapist, said: “Nurses can bleep us and we can see people within 15-20 minutes to assess whether a patient will be well enough to go home.

“We also do home visits with a lot of patients so that we take them home and check how well they can cope and what they need help with before we leave them there.”

There are also strong links with other parts of the hospital which mean patients have quick access to diagnostic tests like scans and x-rays.

While the unit is working well, demand is increasing all the time. The number of patients coming through the unit has increased by 30 per cent in the last year alone and there are tough times ahead for the hospital as they battle to recover a £16.7m debt, but the staff remain unfazed.

Dr Bose said: “There's obviously a lot of change going on in the hospital but we feel it's very important to engage with that and try and deliver the best services that we can for patients within these circumstances.”

Have you been treated in the Acute Medical Unit? Tell us about your experience. Write to Your Letters, Evening Star, 30 Lower Brook Street, Ipswich, IP4 1AN or e-mail