Surprise inspection by top troubleshooters at Royal Sussex’s A&E

TROUBLESHOOTERS have been called in to help a hospital emergency department in crisis.

Inspectors made a surprise visit to the Royal Sussex County Hospital’s accident and emergency department and will remain there all week to check on progress.

Hospital bosses invited specialist troubleshooters from the NHS Emergency Care Intensive Support Team (ECIST) to help resolve issues at the hospital.

They will now try to improve the speed of handover of patients from ambulances to the A&E department, ensure patients are moved off wards when they no longer need to be there and make sure emergency measures can be implemented when services are under pressure.

Last month The Argus revealed that Brighton’s coroner had raised concerns after five deaths in the department.

A spokesman for the Care Quality Commission confirmed they were conducting an unannounced inspection this week.

He added: “It is an unannounced inspection but it is routine.

“The hospital didn’t come up very well after its last inspection, so making repeat visits is something we do at a lot of hospitals.”

The Brighton and Sussex University Hospitals Trust chief executive Matthew Kershaw notified staff yesterday.

The trust said they had also invited the ECIST specialists in to help make improvements after Brighton and Hove coroner Veronica Hamilton-Deeley criticised both A&E and the AMU. The coroner raised concerns over the “apparent abandonment” of a patient whose death was accelerated by her treatment in AMU.

A spokeswoman for the Brighton and Sussex Hospital’s NHS Trust said ECIST made five recommendations to improve the speed with which people receive care.

She said a clinician will be based in the waiting room to help direct patients to the most appropriate care.

This includes care outside of the emergency department.

There were recommendations around operational procedures to support consistent and swift handover for ambulance arrivals.

She added: “ECIST have made recommendations such as auditing our wards on the way in which they plan for patients leaving hospital. This will ensure we are following best practice in all parts of the hospital and that patients are not staying for longer than they need acute hospital care.

“The focus is on supporting patients to go home in the morning so that they can settle in at home and so that the beds are freed up early in the day for new admissions.”

She said the team recommended having an ambulatory care unit to provide specialist advice to GPs in order to avoid hospital admissions and identify and treat patients coming to the emergency department who do not need the specialist input of emergency care clinicians.

She added: “Every part of the local health system plays a role in supporting the flow of patients through the emergency department.

“This ECIST recommendation is around using a tool which triggers organisations, services and individuals to implement agreed actions when the emergency department is under pressure.”

IMPROVEMENTS NEEDED

THE five Emergency Care Intensive Support Team recommendations for the Royal Sussex County Hospital:

• Navigation role – a clinician based in the waiting room to direct patients to the most appropriate care.
• Rapid handover for ambulance arrivals.
• Patients discharged from wards so that they are not staying for longer than they need.
• Ambulatory care unit – giving specialist advice to GPs in order to avoid hospital admissions
• Escalation – implementing actions across trigger organisations and services when the emergency department is under pressure.