Working as One - UEC transformation in Gloucestershire
The challenge Like much of the country, Gloucestershire’s hospitals are under significant pressure, with demand forecast to continue increasing due to an ageing population. Delivering urgent and emergency care (UEC) services which are equipped to deal with the demands of today and the future is critical. Committed to evidence-based improvement of UEC services, One Gloucestershire commissioned Newton to undertake a detailed pathway review, covering delivery of care in the community, hospital arrivals, during hospital stays, and intermediate care journeys post discharge. The review found a number of challenges including lengthy ambulance handovers, long waits for acute beds, and challenges in discharging residents resulting in lengthy stays. Disconnected services and lack of awareness of referral pathways meant that residents often were not supported to stay in their homes and communities. Fundamentally, there was mismatch between demand for care and capacity in the system. Aligning around a vision for citizens and clear evidence of where the most impactful change would be, the Working as One programme was conceived to advance integrated ways of working and enable more citizens to lead healthier lives, getting the care they need, in the right place, at the right time.
The impact Working as One is an example of a system- wide partnership aligning around a vision for its population. It works in a truly joined-up way across a hugely complex change programme to deliver improved outcomes for the individuals in its care. The improvements in flow have seen the hospital occupancy reduce from over 105% to the low 90s. This has been achieved in a period where demand has been rising, and the system has undergone some significant reconfigurations of its bed base, as well as consolidating most ambulance conveyances at a single site. Improvements to discharge have seen the NCTR queue reduce, without using additional beds in the community, and the system is now using fewer beds than before. This is enabling better outcomes for patients, and the acute trust has seen impact on their delay related harm and mortality outcomes. Ultimately, people are spending fewer nights in a bed that isn’t their own, and are achieving more independent outcomes than they were previously.
10
Made with FlippingBook - Online catalogs