‘Urgent escalations of people being moved from beds to corridors’ occurring weekly at Altnagelvin A&E, says MLA
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00:00My department has taken a number of steps to improve patient flow at the
00:04Aldergelvan Area Hospital. An enhanced minor injury unit was opened in March of
00:09this year. It is a phone first led service. It operates from 8 o'clock in
00:15the morning to 9 o'clock at night, seven days a week. And it's my expectation this
00:20unit will see some 20,000 minor injury patients per year, thus 20,000 people
00:27avoiding the need to attend the emergency department. My department has
00:31also commissioned an enhancement to the Aldergelvan ambulatory care unit,
00:35operating from 9 a.m. to 9 p.m. every day, seven days a week. It is expected to
00:40provide almost 20,000 bookable appointments a year. A consultant-led
00:44respiratory hub is also available, with clinics operating two and a half days a
00:48week, offering capacity for 1,200 patients each year, as well as providing
00:53seven-day respiratory consultation cover for the emergency department and
00:58inpatients referral. Western Health and Social Care Trust has established a
01:03control room in the hospital to proactively manage the flow of patients
01:06through the hospital site and into community services. And a discharge
01:11coordination team is promoting earlier discharges and improved weekend
01:15discharge rates for patients who have been assessed as medically fit. In
01:19addition, the trust is engaged with GP practices to embed direct referral
01:23pathways from primary care into the hospital-at-home service. Work between
01:28the trust and care homes is also helping to avoid admissions for residents, with
01:32plans in place to manage agreed conditions by care home providers. As
01:37well as redesigning seven general residential beds to increase capacity
01:41for patients with dementia, the trust will open a further 11 beds for dementia
01:45patients and eight general nursing beds to help improve flow and discharge from
01:51Adelaide. Thank you Minister for the update on the range of measures.
01:59Unfortunately at this moment in time things aren't improving, despite the fact
02:04of we have the minor injuries etc as you've mentioned, and despite the fact on
02:09a weekly basis there is an urgent escalation where people are removed from
02:14their beds onto corridors. Do you believe that additional work needs to be done
02:19regarding any medical gaps regarding specialisms and staff to actually reduce
02:25the number of people? 29% of people are with more than 12 hours of A&E
02:30out in the garden. Well I thank the Member for the supplementary and what I
02:33would say to her is what we're trying to do is remove the second assessment so a
02:38lot of people end up in a hospital because they start off with their GP
02:42where they are assessed and then they're sent to the emergency department of an
02:46acute hospital where they are assessed a second time. I think the future is to do
02:51away wherever possible with the second assessment and for the GP to be
02:56able to refer the patient directly to a specialist service within the hospital
03:00and you will see that some hospitals as well as having emergency departments and
03:04minor injuries units now have urgent care departments and that's what I'm
03:10talking about where you can be referred by a GP directly to an urgent
03:15care department and and the kind of theory behind that is that you do have
03:20more specialists and indeed the future of health care and the past of health
03:25care is a development towards fewer generalists and many many more
03:29specialists and that is the future that is the direction of travel.
03:33Dr. Ergan.
03:35Thank you Minister for his answers. I'd like to commend the heroic efforts of our staff in the
03:40emergency department at Altony Galvan. Could the Minister provide us with an
03:44update on the Western Trust business case for an enhanced emergency department
03:49at Altony Galvan?
03:51Minister. Well I thank the Member for his question. I visited
03:54Altony Galvan a few weeks ago and we looked at some of the new facilities
03:58that are in place there and I was updated on the fact that there is a plan
04:02for a new emergency department. I would have to write to the Member if he's
04:06looking for exact details in terms of where that outline business case is and
04:11what the timeline is for completion.