Northampton General Hospital aims to defuse A&E timebomb and reduce the number of beds it needs by more than 100

Dr Sonia Swart

Dr Sonia Swart

4
Have your say

Significant reductions in NGH admissions will be seen by March, its chief has said, in what would be the first slackening of pressure on Northampton's ailing A&E services in five years

Dr Sonia Swart has warned for some time that staff are in danger of being unable to cope with relentlessly increasing numbers of urgent cases and patients who are more acutely ill.

But she has now offered a light at the end of the tunnel for staff, saying that a new NHS programme will see a reduction in the time people spend in hospital - freeing up 113 beds -, reducing admissions by 10 people per day and slashing delayed discharges by 60 per cent.

Dr Swart said: "Published studies indicate that one of the key impediments to efficient care is the space and beds available.

"In this regard, the 10 per cent of patients who stay over seven days occupy 65 per cent of the beds.

"A relatively small change in this group would free a lot of bed capacity, be much better for patients, save money and allow for greater efficiency in our hospitals, thereby improving the A&E target as well."

Dr Swart said a current lack of adequate home care services is a key factor in Northamptonshire and that lack of space on hospital wards is another cause.

But the oncology doctor has come to the conclusion that pressures cannot be alleviated by simply opening up short-term wards - something that is impacting on care at NGH's gynae day unit and heart and kidney centres when they are used as escalation areas.

She said: "For me what is becoming clearer with every passing week is that the A&E crisis has at its heart the lack of sufficient hospital space and the ability to move people through it.

"We are using more bed days, but we do not have enough beds. We are treating more patients and are using more short stay beds.

"Our patients have more co-morbidities and those who need to stay longer need more bed days than they did before.

"The effect of this is a daily battle rhythm that centres around identifying adequate beds for the patients who require admission.

Dr Swart said that just opening many more beds is not only unaffordable, it doesn’t really get to the root of the problem.

She said: "This can be a demoralising cycle of activity causing significant pressures for our staff who remain passionate about providing high-quality care and who deliver excellent care on a daily basis.

Despite this, we are failing to meet mandatory performance targets for urgent care and we know that this provides a risk to quality and safety.

"That is why we must have a way of doing something different in terms of the way we provide care."

The pressure-relieving schemes have been developed with the wider NHS and social services and will be monitored through a local A&E/Urgent Care board.

It will support a portfolio of 14 programmes of work that will be executed as a total package, rather than in isolation.

The categories are:

1. Reduce admissions to hospital

2. Improve the efficiency of the treatment of patients during their hospital stay (so they stay for a shorter time, their experience is better and costs are less)

3. Improve the way patients are discharged into the community so reducing their length of stay.