Taunton and Somerset NHS Foundation Trust

A decline in emergency care performance had led to 70% increase in breaches of the national four hour standard.

The CLEAR project identified the following issues:

  • 6.6% increase in attendances in emergency care, combined with a 43% increase in acuity.
  • Limited estate for emergency care, causing overcrowding and incongruity with patients’ needs.
  • Processes for paediatrics and older people’s care limited patient flow.

New ways of working including:

  • Multidisciplinary team involvement early in the pathways for children and older people.

New models of care:

  • Co-located senior-led triage.
  • Acute assessment unit for older people.
  • Paediatric assessment unit.

New models of workforce:

  • Upskilling of reporting radiographers.
  • GP involvement in walk-in triage, with better links to community and primary care services.
  • Improvements in upskilling, recruitment and retention due to engaged and empowered staff.
  • Improvements in safety and care with effective staffing and decision-making as a result of evidence-based new models of care.
  • Local solutions to urgent care challenges delivered by multidisciplinary team working.
  • Clinical capability for transformation embedded within the system.
  • Potential savings identified as £1.9 million per annum.

“Training is provided through e-learning; didactic teaching from experienced NHS clinicians, managers and data analysts; and close supervision from experienced mentors. In this way the fellows are able to…understand NHS and local trust processes…[and] analyse patient flow and workforce data to put forward innovative ideas and suggest new ways of working. The CLEAR programme also delivers the essential generic skills required by the GMC’s professional capabilities framework to provide safe, effective, high quality care…allowing the Fellows to develop into effective, motivated leaders in their fields in the future.”

Dr Michelle Hayes – Chelsea and Westminster Hospital NHS Foundation Trust, CLEAR Fellow

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