From Board to Ward – June 2024

We’ve got plenty of good progress to share this month, with particularly good news for patients needing urgent and emergency care, urological problems and those waiting for orthopaedic operations.

Highlights from June’s Board: ??

In June’s Board to Ward we share three key highlights to demonstrate key progress on projects, decisions made and share in an open and transparent way some key developments. Our three for June:

• Reducing waits for orthopaedic patients
• Quicker care for patients with urgent urological problems
• A focus on Urgent and Emergency Care

Reducing waits for orthopaedic patients

Our Board meeting heard that we opened our new Orthopaedic Theatres opened last week (17 June) and they are now fully operational. The new orthopaedic theatres are initially operating Monday to Friday between 8am and 6pm with additional lists provided at weekends to enable patient waiting times to reduce. The theatre facility will support complex and non-complex operations and provide an excellent teaching environment for orthopaedic trainees. The commencement of the new theatres, together with an increase in the number of postoperative, ring-fenced beds will increase throughput to 154 cases a month, of which 98 will be arthroplasty, a substantial increase on the numbers currently being treated, which will enable us to reduce our long waiting list and treat patients more quickly.

Quicker care for patients with urgent urological problems and the impact this has had on staff

Senior nurse and Unit Manager of the Chestnut Urological Investigation Unit, Tracey Whittingham, came along to talk to Board about their move to a brand-new unit and the impact on patients and staff. Tracey described how the urology unit used to be situated in a cramped environment with just five patient rooms, no staff room, and a crowded office in Derriford Hospital. Patients were having multiple appointments because of lack of space and waiting times were increasing. The team had a dream for how they wanted to deliver care for patients with urology problems in the south west and shared this with the senior leadership team, who supported them with the building of a brand new unit.

They moved into the new Chestnut Unit last year. This has five consulting rooms, 6 procedure rooms, lead-lined rooms for diagnostics and treatment, a cystoscopy lab and a minor ops room, waiting rooms big enough to accommodate the number of patients they see, areas for doctors to work in and staff rooms.

Tracey described what a difference this had made: to patients and to staff. They now offer one-stop clinics so patients can have their investigation, diagnosis, and treatment in the same day. ?Tracey also described the additional Same Day Emergency Care service the unit has set up for patients. Tracey said they are the first unit in the country to do this and you can hear more in our video about the difference it is making to patients with urological problems attending as emergencies. Watch our Improving Urgent and Emergency Care: Urology SDEC video.

Tracey described how they have seen approximately 80 emergency patients in the first month and avoided 76 of them having to go to the Emergency Department. She finished by saying: “The service we can now deliver to our patients is outstanding, staff wellbeing has increased and we feel really cared for by the organisation, people believed in us and got on board with our dream for patient care.”

A focus on Urgent and Emergency Care

Our 4hr performance has improved for three consecutive months from March to May 2024, increasing +9.6% to 63.7%. This means nearly 64% of patients coming in as emergencies are seen and treated within 4 hours.??This is an 11.4% improvement on the same month last year (May 2023 = 52.3%) and whilst significant improvement is still required , our benchmarking position is improving with the improvement associated with the on-site Urgent Treatment Centre, which is currently being built, still to come. We have also seen a reduction in 3,000 hours of ambulance hours lost to delays but despite this we remain a significant outlier in terms of our current performance.

We continue to make substantial progress on the development and delivery of the ‘One UEC Plan’. We have committed to fund an additional 6 whole time equivalent consultant posts in the Emergency Department of which 3 have been recruited and a further 3 are in progress which will enable improved senior decision-making capacity aligned to demand during the day.

We are waiting on the outcome of our bid for national capital funds to progress the expansion of our Same Day Emergency Care (SDEC) and Medical Assessment Unit (MAU) capacity. In July 2024 we will be undertaking some interim actions which will see pre-operative assessment relocated from Outpatients, enabling the current SDEC space to be relocated to Outpatients, so that the right sizing of our Medical Assessment Capacity can be completed. This will enable the new medical model to commence improving early assessment by senior decision makers in late July 2024. This will increase our MAU capacity to 72 beds and increase the number of patients being seen in SDEC by 16 per day. We are working with our community provider, Livewell Southwest, to locate our urgent care response services in the MAU/ED/SDEC in July 2024 to further ‘pull’ patients who would benefit from these admission avoidance services. These changes are designed to further improve 4 hour waits and, in turn, ambulance waiting times across the services.

We are also working on:

• Creating more hot clinics so patients can return the next day and be seen in a specialist clinic
• Improving Early Supported Discharge for patients following stroke
• Community care for patients with fragility fractures and those needing further intravenous treatment

And finally ….

Colleagues from professions across University Hospitals Plymouth NHS Trust (UHP) came together in celebration of healthcare research at the Health and Care Research Conference 2024. The conference was ‘sold-out’. Those who attended on the day were given the opportunity to find out how to take the first steps into research, meet patients who have been part of research, discuss innovative methodologies, and network with like-minded individuals. Read more about the Health and Care Research Conference 2024

We welcomed two of our new non-Executive Directors, Dr Helen Smith and Jabo Butera, who have recently joined us. Helen is a forensic psychiatrist who brings extensive experience in both leadership and quality improvement. Jabo is Managing Director of Diversity Business Incubator, a non-executive director at Devon and Plymouth Chamber of commerce,?and a non-executive director of South West Business Council. He brings expertise in an inclusion and equity approach in business development and corporate governance reflecting human-centred values.

Want to know more?

Every month our Board leaders meet in public to assess how we’re doing for the patients and communities we serve, how we’re doing for our staff, our achievements, our challenges with a big focus on what we’re doing to address them and what our plans are for the future.

You can see who makes up our Board at University Hospitals Plymouth on our Trust Board page

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Do you want to get involved?

• Did you want to ask the Board a general question? If you do, please let us know by emailing [email protected] and we will put it to the leaders and get an answer at the next Board meeting.
• Would you like to attend and watch the Board meeting? Dates, venue details and papers all here: https://www.plymouthhospitals.nhs.uk/trust-board-meetings-and-papers