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BEHIND THE HEADLINES: Hospital handover delays

HOSPITAL handover delays have been the subject of intense scrutiny by politicians and the media.

Resolving these delays remains a top priority of the Welsh Ambulance Service and the wider NHS in Wales, so here we set out what we’re doing to try and minimise delays.

What is a hospital handover?
Paramedics can only hand patients over to hospitals when staff there are ready to take charge of them.

This process is supposed to take no longer than 15 minutes, but when hospitals are busy it means our crews have to wait – often parked outside of the emergency department.

While a crew is waiting to hand over a patient, it means that they are unavailable to respond to other 999 calls in the community.

Gordon Roberts, the Trust’s Interim Assistant Director of Operations, said: “Hospital handover delays are not good for anyone – not for our crew, not for the hospital and least of all for the patient.

“Reducing delays requires the whole health system working effectively to ensure that there is capacity within the hospital to support good patient flow and to reduce the pressure in emergency departments.”

What are you doing about it?
Individual delays are escalated to senior managers at all affected hospitals, and team leaders from the ambulance service then liaise with the emergency department staff and help speed up the flow of patients through the department.

Ambulance crews continue to provide clinical care and attention for patients as they wait to be admitted into hospital and liaise with hospital staff to help prioritise those patients with greatest clinical need.

To support good patient flow, the Trust provides a number of dedicated discharge and transfer vehicles to take patients home to release beds in hospitals which, in turn, supports the improvement of patient flow in the emergency departments.

We have also introduced a number of Alternative Care Pathways to reduce unnecessary admissions to hospital and provide the patient with appropriate care closer to home. Since September 2012, more than 10,000 patients have been referred on an alternative care pathway instead of having to go into hospital, and the Trust is working closely with Local Health Boards to implement a wider range of pathways.

Advanced Paramedic Practitioners (APPs) also provide a wider range of specialist healthcare at the scene of an incident or at a patient’s home. Approximately 20 APPs operate throughout Wales with a further 31 currently in education and training.

And in February 2015, in partnership with all of the health boards in Wales, the ambulance service agreed national handover guidance which has helped our ambulances to be released in a more timely fashion.

The figures
Here are the number of ‘lost hours’ at hospitals across Wales in the last 12 months as a result of handover delays.

2014
September 3,115
October 3,258
November 4,275
December 5,459

2015
January 5,795
February 4,204
March 4,201
April 3,649
May 3,357
June 2,919
July 2,069
August 2,457

Gordon said: “We’re really pleased that the number of hours lost as a result of handover delays are reducing in some areas but there is still work to be done.

“We’ll continue to work with Local Health Boards and Welsh Government to drive down these system-wide delays, but we need the public’s support, especially during the winter period which is traditionally a very challenging time for the unscheduled care system.”

What can the public do to help?
“We are reminding the public to use our ambulance service appropriately so that more of our crews are available to help those in a genuine emergency,” said Gordon.

“Lots of people who call 999 simply need to see a pharmacist or GP. Treatment for minor injuries, such as cuts, bites, muscle and joint injuries is offered at your local Minor Injuries Unit, where there is no need for an appointment.

“For advice and treatment of most illnesses, there is NHS Direct Wales, where you can access confidential health advice and information 24 hours a day, seven days a week, by calling 0845 46 47 or visiting www.nhsdirect.wales.nhs.uk  

“Please only call 999 and visit the Emergency Department if you’re seriously ill or injured or your life is at risk.”