Making 7 day services work in emergency care – The Northumbria Way

• Opened June 2015 – England’s first purpose built, dedicated emergency care hospital

• Over 10 years worth of planning

• Huge commitment to involving staff in the design and planning

• Brings together all acute emergency admissions

• Emergency medicine consultants on site 24/7

• 7 speciality wards

• A&E departments at Hexham, Wansbeck and North Tyneside now

Urgent Care Centres

Background

OutpatientsDiagnosticsDay casesElective Surgery

Sub acute in-patients

A&EEmergency Admissions

Acute in-patients

Minor injuries

OutpatientsDiagnosticsDay casesElective Surgery

Sub acute in-patients

A&EEmergency Admissions

Acute in-patients

Minor injuries

OutpatientsDiagnosticsDay casesElective Surgery

Sub acute in-patients

A&EEmergency Admissions

Acute in-patients

Minor injuries

Alnwick

SpecialistEmergency Hospital

OutpatientsDiagnosticsDay casesElective Surgery

Sub acute in-patients

A&EEmergency Admissions

Acute in-patients

Minor injuries

Acute in-patients

A&E

Emergencyadmissions

“hot” diagnostics

OutpatientsDiagnosticsDay casesElective Surgery

Sub acute in-patients

A&EEmergency Admissions

Acute in-patients

Minor injuries

Focused around 3 major sitesFocused around 1 major “emergency site”

OutpatientsDiagnosticsDay casesElective Surgery

Sub acute in-patients

A&EEmergency Admissions

Acute in-patients

Minor injuries

• Northumbria now largest receiving emergency department in the North East

• Emergency ambulances now bring all emergency admissions to one centralised point – impacting on handover times

• Walk-in attendances have been higher than anticipated

• Pace of service delivery can take its toll on staff

Challenges

• Responding to a 15% increase in urgent and emergency care activity

• Northumbria one of only a handful of trusts nationally meeting the 95% within 4hrs target in 2016.

• A 14% reduction in emergency admissions to hospital resulting in a £6 million saving for the health economy

• Senior clinical decision making from consultants on site 24/7

• Almost 80,000 radiology examinations performed,

resulting in much quicker diagnosis and treatment

Successes

CQC National Inpatient Survey

Rank Trust

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=1 The Royal Marsden n/a 9.5 9.1 9.0 9.3 9.2 8.8 9.2 8.4 6.8 9.0 8.8

=1 Queen Victoria Hospital n/a 9.4 9.1 8.8 9.4 9.4 8.9 8.9 8.4 7.1 8.9 8.8

=1 Liverpool Heart and Chest n/a 9.3 9.6 9.1 9.5 9.4 8.9 8.8 8 6.2 9 8.8

=4 The Clatterbridge Cancer Centre n/a 9.5 9.6 8.9 9.3 8.9 8.7 8.6 8.2 6.9 8.7 8.7

=4 Papworth Hospital n/a 9.2 9.4 8.9 9.3 9.2 8.7 8.8 8.2 6.4 8.9 8.7

=4 The Christie n/a 9.4 8.7 8.9 9.3 9.2 8.7 9.2 8.1 6.6 8.9 8.7

=4The Robert Jones and Agnes Hunt

Orthopaedic Hospitaln/a 8.9 9.2 9.1 9.4 9.0 8.6 8.9 8.0 6.4 9.0 8.7

=8 Liverpool Women's n/a 9.3 8.9 n/a 9.3 9.2 8.7 9 7.8 6.3 8.8 8.6

=8 The Royal Orthopaedic Hospital n/a 9.0 8.7 9.1 9.3 9.0 8.5 8.8 8.0 6.5 8.7 8.6

=10 The Newcastle Upon Tyne Hospitals 9.4 9.2 8.6 8.7 9.2 9.1 8.5 8.8 7.7 5.9 8.6 8.5

=10 Northumbria 9.2 9.1 8.7 8.8 9.1 8.9 8.5 8.7 7.8 5.9 8.5 8.5

Out of 149 Trusts, Northumbria is ranked joint 10

Patient Experience

CQC National Inpatient Survey

Section Scores 2014 nationally Section Scores 2015 nationallyThe Emergency/AE Department 8.7 About the same The Emergency/AE Department 9.2 Better

Waiting List & planned Admissions 9.3 Better Waiting List & planned Admissions 9.1 About the same

Waiting to get to a bed on a ward 7.8 About the same Waiting to get to a bed on a ward 8.7 About the same

The hospital and ward 8.2 About the same The hospital and ward 8.8 Better

Doctors 9.0 About the same Doctors 9.1 Better

Nurses 8.7 About the same Nurses 8.9 Better

Care and treatment 8.0 About the same Care and treatment 8.5 Better

Operations and Procedures 8.6 About the same Operations and Procedures 8.7 About the same

Leaving Hospital 7.7 About the same Leaving Hospital 7.8 Better

Overall views of care & Services 5.9 About the same Overall views of care & Services 5.9 About the same

Overall experience 8.1 About the same Overall experience 8.5 About the same

CQC National Inpatient Survey

10%

88%

2%

Questions 2014

Better than (6) About the same (53) Worse (1)

38%

62%

0%

Questions 2015

Better than (24) About the same (39) Worse (0)

Inpatient Survey – Domain 4 By Domain

Trust Scores Performance

Domain 2015/16 2014/15 Diff80th percentile

for 2015/16Performance in top

20% for 2015/16

Access and waiting 88.4 88.2 +0.2 87.3 Yes

Safe, high quality, coordinated care 73.6 69.8 +3.8 68.8 Yes

Better information, more choice 75.5 73.4 +2.1 71.8 Yes

Building closer relationships 89.8 88.6 +1.2 87.1 Yes

Clean, comfortable, friendly place to be 86.7 81.6 +5.1 82.7 Yes

Overall 82.8 80.3 +2.5 79.2 Yes

Clean, comfortable, friendly place to beTrust Scores Performance

Question 2015/16 2014/15 Diff80th percentile for

2015/16Performance in top 20% for

2015/16

Q15: Were you ever bothered by noise at night from other patients?

76.3 59.5 +16.8 67.5 Yes

Q16: Were you ever bothered by noise at night from hospital staff? 87.7 77.1 +10.6 82.3 Yes

Q17: In your opinion, how clean was the hospital room or ward that you were in?

94.6 90.9 +3.7 91.9 Yes

Q21: How would you rate the hospital food? 67.5 58.9 +8.6 60.8 Yes

Q39: Were you given enough privacy when being examined or treated?

96.8 93.6 +3.2 96.1 Yes

Q70: Overall, did you feel you were treated with respect and dignity while you were in the hospital?

93.4 92.8 +0.6 92.4 Yes

Q41: Do you think the hospital staff did everything they could to help control your pain?

86.1 85.1 +1.0 85.6 Yes

Real Time Patient Experience

Since the opening of The Northumbria patient experience real time domains have improved in the following areas:

• Coordination *• Respect and Dignity • Involvement *• Doctors and Nurses*• Pain Control*• Noise at Night• Kindness and Compassion *• Overall Experience*

* significant improvement comparing the first year of The Northumbria being open, against the previous

year

• Scale of change

• The quality of clinical leadership

• Ability to do this whilst keeping all other hospitals open

• Involvement of staff

• Involvement of local communities

• Patient Experience scores have continued to increase

What makes this stand out:

Thank You

Any Questions?