News

‘Care model must be transformed’

Tuesday, 9 January 2018

THE Project Director of the Daisy Hill Hospital Pathfinder Project, Dr Anne Marie Telford, has stated that the final report is not just about the Emergency Department (ED) but transforming the model of acute care for the population.

In her summary of the project, which is included in the final report, Dr Telford explained that a sustainable long-term solution was required in response to the inability to recruit senior medical staff to work in the ED.

A needs assessment process demonstrated that the models of care provided both in and out of Daisy Hill had to adapt and change if the Southern Trust was to deliver a long-term service to the Newry and Mourne population.

"A robust primary care service both in and out of hours is essential, otherwise the numbers of attendances at ED will continue to rise at a rate which is out of keeping with population demographic change," explained Dr Telford.

"There is policy advice, both regionally and nationally, that alternative pathways to ED should be in place to assess stable patients who are thought by their GPs to need urgent investigation or admission.

"This differs from the older model, which was not sustainable, of direct GP admission to a bed."

The Pathfinder report recommends establishment of a direct assessment unit, staffed jointly by medical, care of the elderly and ED staff, in close proximity to ED, which will provide telephone advice to GPs, ambulatory assessment and diagnostics.

Dr Telford added that it was "vitally important, but will take time" to embed a culture change that accepts that a long stay in hospital is not the safest place to be, especially for those who are elderly and at risk of confusion, falls and infection.

"This culture change is required among patients, carers and, just as importantly, among hospital staff," continued Dr Telford.

"Work done as part of the Pathfinder project has shown that in Daisy Hill Hospital, as in other hospitals in NI, a substantial number of patients do not have a medical need to be in hospital. It is very important that this model of care does not continue."

During the project much time was spent considering workforce issues and a survey of ED doctors in NI, who are training to become consultants, stated that they wish to work on reasonable rotas and in hospitals that have appropriate supporting infrastructure.

The recommendations within the report include an increase in ED medical and nursing staff but there may be challenges in filling those posts, despite the increase in potential consultants finishing their training in the next three years.

Finally, Dr Telford added: "I would like to thank the Southern Trust Senior Management team and members of the Pathfinder Group and its workstreams.

"Particular thanks are due to the members of the community, both those who provided their views during the stage before the formal representatives were nominated to workstreams, as well as those who attended our meetings.

"I have also had the support of an excellent project manager, Ms Charlene Stoops, and project team compromising Dr Diane Corrigan, Dr Brid Farrell and Dr Rachel Doherty."

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