Providing top quality care from hospital to home
Welcome to August's column, bringing you up-to-date with developments at Berwick Infirmary.
This month I’d like to feature two services that are benefiting patients in our community by helping them to have a smooth transition from hospital to home, and enabling them to have a vital assessment before surgery closer to home.
The first is our hospital to home team.
This team ensures that when patients are ready to leave hospital, their transition from the hospital ward back home is as seamless as possible.
The team makes all the necessary plans for patients’ safe and timely discharge, making sure that arrangements for ongoing care and support, including any equipment they may need, are in place for them to manage at home.
Berwick Infirmary is covered by the North Northumberland hospital to home team, which also assists patients in Alnwick Infirmary and Rothbury Community Hospital.
It consists of two social workers and two occupational therapy assistants, and together they are having a huge positive impact on patients and their families.
The team, however, does not work in isolation.
It is part of our wider health and social care team here in Berwick, all working together to provide the best care for our patients in the best location to suit their needs, while planning for their discharge from hospital as early as possible.
The social workers attend the multi-disciplinary meetings on the ward.
Here, they join nurses, doctors and other healthcare professionals to enable all aspects of patients’ treatment to be discussed. This aims to ensure that their care is as integrated as possible and that patients’ families are involved throughout.
It’s timely that we focus on this service as we’ve been singled out as one of the top organisations nationally for discharging older people from hospital in a safe and timely manner.
Our chief executive David Evans recently gave evidence at the House of Commons Committee of Public Accounts, held to discuss the issue.
Described as having one of the best records on discharging older patients anywhere in the country, the committee praised our long-standing relationship with Northumberland County Council and the fully-integrated approach to managing patients’ every care need.
Across the country, official figures show that the number of delayed transfers for older people – where a patient remains in hospital after the clinicians and professionals involved in their care decide they are ready to leave – increased by 31 per cent between 2013 and 2015.
The committee highlighted that in our trust, the number of delayed transfers of care in 2015/16 was only 10 days, compared to almost 18,000 days in other parts of the country, which is credit to the hard work of all our teams.
There is another strand to the hospital to home team’s work in that it provides an immediate response service for GPs to prevent a person being admitted to hospital because they’re unable to manage without a social care intervention.
This could be providing a piece of equipment such as a commode or a handrail, which will enable someone to stay at home.
The service is only for people without their own social worker or key worker, and the team is able to provide a response within two hours of being contacted.
It’s always best for people to stay in their own surroundings for as long as possible, provided the right help and support is in place, and this team is key to enabling this to happen.
The second service I want to highlight is pre-operative assessment.
This is a vital appointment that has to take place before a patient has surgery, and in dozens of cases these appointments are now taking place here at Berwick Infirmary.
The aim of the pre-op assessment is to carry out any investigations or tests that need to take place before the operation can go ahead to reduce the risks from having the surgery.
This could include taking a blood sample to be tested, as well as a taking a swab from the skin to screen for MRSA, which is standard practice for anyone being admitted to hospital for planned care.
This is because many people carry MRSA on their skin, which is usually harmless. However, it can cause problems if the bacteria get into the skin.
If an MRSA presence is found on a patient’s skin, a simple treatment can be given to get rid of as much of the bacteria as possible before they come in for their operation, minimising the risk of themselves and others becoming infected.
At the pre-op assessment, the nurse will go through a patient’s medical history, including previous operations and any medications they’re taking.
They will also provide any information the patient will need to know before they have the operation, such as when to stop eating.
We know that many patients find the prospect of having an operation daunting, and the assessment is about giving the patient as much information as they’d like and, above all, reassurance.
It’s also an opportunity for patients to ask any questions.
As part of our commitment to deliver as much care as we can locally, we have worked hard over the last couple of years to increase the number of pre-op assessments we carry out in Berwick.
We hold a monthly clinic here at the infirmary, led by a specially-trained nurse with support from nursing assistants.
This clinic reviews patients who will be having a general anaesthetic and patients who are scheduled to have a local anaesthetic, but who, for a variety of reasons, may need to have to have a general anaesthetic.
Over the last year, almost 70 pre-op assessments have taken place in Berwick, which is 70 people who have not had to travel out of the area for their appointment and is great news.
I’m pleased with the success of the pre-op assessment service so far and know the whole team has a desire to build on this.
We’re currently aiming to increase the number of patients completing the screening questionnaire prior to attending the assessment in order to better utilise clinic time and enable many more patients to be seen in Berwick.
We’d also urge people given an appointment for a pre-assessment at another hospital in our trust to ask whether that could take place locally.
While we aim to do as many pre-op assessments as we can in Berwick, patients undergoing certain types of surgery will need to travel further afield because they have to be seen by other health professionals at the same time.
These services are just two of the many we have here at Berwick, and I’d like to thank staff working in all our services for their continued hard work and dedication.