Southend A&E is back on track

Dr Howard with members of staff in the A&E department

Dr Howard with members of staff in the A&E department

First published in News by

SOUTHEND Hospital A&E staff are jubilant after successfully cutting waiting times which means they are now outperforming other Essex hospitals.

The hospital came under fire from health regulator Monitor after consistently failing to meet a Government target of seeing 95 per cent of patients within four hours.

The hospital was ordered to improve its service with the implementation of an action plan.

In fact, an improvement plan has been in place since last August and for the past three months, it has exceeded the target, reaching more than 98 per cent at one point.

The turnaround is all the more remarkable as, based on current levels, the number of patients seen in the hospital this year is set to hit 100,000, when it was designed to cope with thousands fewer.

Dr Caroline Howard, Southend Hospital A&E clinical lead, said: “The improvement has been a long process. Emergency medicine all over the UK is in a bit of a crisis at this time. One reason is a lack of staff, because it is such a high-pressure job. We can’t say we’re full and close – we have to just carry on.

“It’s been a lot about recruitment. We’ve been looking abroad and at other recruitment schemes and looking at role changes, offering better career progression for nurses and better contracts for senior staff.”

For example, the hospital has long supported emergency nurse practitioners, where senior nurses are trained to diagnose and treat minor conditions.

They can now undergo a sixyear training programme to become advanced nurse practitioners with full diagnostic ability taking them to the grade of a doctor just below the level of a consultant.

It’s a scheme which has seen other hospitals improve recruitment levels.

The way patients are initially seen and assessed has also changed, with a senior doctor on hand to quickly assess a patient’s needs and either discharge or refer them for admission.

Dr Howard said: “We have a rapid assessment team which can take blood, insert cannulas, assess what the problem is, order investigations and send them to a special area or discharge them.

“A lot of patients who attend A&E shouldn’t be there, so having a senior doctor assessing them and discharging them quickly has a major impact.”

The department itself was built 13 years ago to treat about 60,000 patients a year, so plans are under way to expand the building, taking over an adjacent ward with a dedicated paediatric area. The department currently has 40 doctors and 70 nurses, but this is set to grow when the department expands.

Despite the previous targets not being met, Dr Howard believes her team did the best it could for patients.

She said: “Problems with Mid Staffordshire happened because there were unsafe transfers and admissions.

Patients were moved and discharged unsafely. We would never go down that road.

“We breached targets, but continued to provide good clinical care. We had complaints about waiting times, but not about the care we gave.

“Our targets were already improving when Monitor gave its report, so it was especially upsetting for staff to see the department labelled the worst in the country.

“We have met our targets for May, June and July and, on a number of occasions, have been the only trust in Essex to meet that target.

“If we continue like this for the quarter, we’ll be the best performing trust in Essex.”

Dr Howard added: “I came here in 2005 as a trainee registrar.

“It is the best department I have worked in ten years. The staff are superb.

“Because of the national shortage of A&E staff, the world is my oyster. I could go anywhere, either here or abroad, with a very attractive salary, but I won’t go, because Southend is by far the best department to work for.”

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