East Kent Hospitals takes steps to cut waits for emergency and planned care ahead of winter 

14 June 2018

Next week is the summer solstice, but East Kent Hospitals is planning for winter.

The Trust is recruiting more staff and speeding up access to scans as part of steps to improve waiting times for both emergency treatment and planned surgery this year – and to protect services from the exceptional pressures seen by the NHS last winter.

Figures released by NHS England today show an improving picture for emergency department waits in east Kent, with the Trust’s emergency departments and minor injury units recording above 80% of patients waiting under four hours to be seen, treated, admitted to a hospital bed or discharged.

The Trust last reached 80% in March 2017. It is eight months into its A&E recovery plan, launched in September 2017.

“The improving figures are good news for east Kent patients, but we need to continue to improve and prepare for high demand on our services this winter,” said Chief Executive Susan Acott.

“Winter traditionally means more very ill patients needing emergency hospital services and last winter the NHS as a whole struggled to meet the demand. Winter also means many planned surgeries cannot take place, which this year had a significant impact on our waiting times for planned surgery such as hip and knee replacements.

“We need to improve these waiting times and so we are taking steps to create more room and have more staff within the hospitals to care for both emergency patients and patients who need planned surgery.”

Demand for planned surgical procedures such as hip and knee replacements has increased by 50% in the last year. The Trust carries out 3,000 planned inpatient operations each year at the William Harvey Hospital, Ashford and QEQM in Margate, with growing waiting lists due to increased cancellations. 76.66% of people in east Kent currently have their operation within the Government target of 92% within 18 weeks.

To date, the Trust has tackled emergency department waits using a range of measures including: a GP working alongside the emergency departments, international recruitment to nursing and consultants posts, building work to improve the environment in the departments and a number of improvement projects aimed at improving different elements of the patient journey through ED, the wards and back home or to a community setting.

The Trust is now recruiting additional nursing staff for the emergency departments and investing in additional radiology services to provide a seven-day CT scanning service for rapid diagnostics. The Trust has also invested in additional medical beds at Ashford and Margate.

The Trust is also scoping a number of options to find more beds and operating theatre space for surgery. One of these is an invitation for the Trust to take part in a national pilot aimed at improving the experience and outcomes for orthopaedic patients suffering a trauma as a result of a fall or accident, as well as those undergoing planned joint operations. It is part of the national GIRFT (Getting it right first time) programme.

It would mean that for the duration of the pilot, the Trust would provide some planned orthopaedic procedures at Kent and Canterbury Hospital, separate from emergency orthopaedic patients who would continue to be seen at WHH and QEQM. The aim is to reduce waiting times and speed up recovery. It would also allow more planned procedures to continue during the winter months.

However, the pilot project requires capital investment for new theatres.

“Should we be able to access the funds we need to take part in the pilot, this is an exciting opportunity to invest in better facilities and equipment which will help patients be seen more quickly for both planned and emergency care,” said Susan. “What’s more, any investment on the K&C site will be of benefit under any of the current potential options for the future reconfiguration of hospital services.”

The local NHS is also working with clinicians, frontline teams and patients on how it can redesign discharge processes to do better for patients. Research shows that staying in hospital for longer than necessary reduces patients’ strength and confidence and their ability to recover. The Trust is working with its partners to reduce unnecessary delays for patients in hospital and redesign discharge pathways so patients get the right support at the right time, and as a result have better health outcomes.

“We know from the safety and quality data that we collect, and from patient feedback, that most of our patients have a good experience of our services,” said Susan. “We have a 97% patient satisfaction rate, but many patients are simply waiting too long for some services.

“Our priority for the year ahead is to cut the length of time these patients need to wait for their treatment. By taking these steps, we hope to achieve that.”