Hampshire Hospitals NHS Foundation Trust opened a new Emergency Surgery Ambulatory Clinic (ESAC) at Basingstoke and North Hampshire Hospital in December 2018. The unit supports patients who require urgent surgical treatment to receive the care they need sooner, such as patients who may require surgery, but whose conditions can be quickly assessed, allowing a treatment plan to be put in place. This includes patients who potentially have conditions such as appendicitis, gallstones and kidney stones.
Alex Whitfield, chief executive of Hampshire Hospitals NHS Foundation Trust, which runs Basingstoke hospital, as well as Royal Hampshire County Hospital, in Winchester, and Andover War Memorial Hospital, said: “The aim of the Emergency Surgery Ambulatory Clinic is to give patients access to many of the services available to inpatients, such as assessment by senior medical staff and diagnostic scans, without needing them to be admitted to the wards.
“It has been really successful, helping to make sure that patients do not need to wait in hospital for investigations, either in the emergency department or after being admitted to the wards”.
“This was one of the projects that we received winter capital funding to complete, so I would like to say a big thank you to the Department of Health and Social Care for helping to make this a reality. I also want to say a big thank you to the team here who worked together brilliantly to ensure that the clinic was open as soon as possible, helping to make sure that we provide the best possible patient care.”
Since its opening in December 2018, the ESAC has been a great success and the Trust has seen a decrease in the average surgical bed days by 20 for those specialties using ESAC. Further, the percentage of surgical patients being admitted for an overnight stay has reduced by 14%. The Trust has seen an incremental improvement with each change they made: opening the unit, introducing hot (48 hour rapid access) clinic slots, and introducing a nurse coordinator receiving and triaging calls.
Hot clinics have been a great success for patients who do not need immediate surgical intervention but do require assessment by a surgical clinician, such as patients with non-specific abdominal pain, abscesses not responding to oral antibiotics or acute exacerbation of chronic surgical conditions like diverticulitis. The clinics allow patients to be seen in a timely manner by a senior surgeon and have decisions made about their care without the need to wait for an outpatient appointment. Further, they also allow patients on the ward awaiting an additional blood test the opportunity to go home and return to have that carried out the following day.
Hayley Blandford, clinical matron for Ward C3 and ESAC, is a strong advocate of ambulatory care and says that running hot clinics will benefit patients, the emergency department and her ward. “I’m really excited because this is the future,” she said. “It’s good for patients because it means that they do not have to spend time waiting, either in the emergency department or on one of the ESAC trollies. Instead they will be able to see a senior decision maker at an appointed time, saving them a lot of stress”.