To receive a presentation from Natalie Forest, Chief Executive and Director of Nursing. Following the presentation, there will be a discussion relating to the recent feasibility study, the Urgent Care Centre and phlebotomy services.
RECEIVED a presentation from Natalie Forrest relating to the new building and service provision at Chase Farm Hospital.
1. Having taken only 2 years to build, the new facility was opened in September 2018, on time and on budget. A core workforce of 300 is supplemented by specialist doctors and nursing, taking the staff numbers up to 1,000.
2. The Care Quality Commission inspection in May 2019 gave an overall rating of ‘good’ for the hospital.
3. 85% of elective surgery patients are treated as day cases but patients with more serious conditions eg, hip replacements are admitted to one of the 42 single bed recovery rooms which provide on-suite facilities and an entertainment system.
4. The range of treatments available in the Urgent Care Centre (UCC) was highlighted, including sprains, strains and broken bones. The UCC is equipped to perform a series of tests including x-rays and ECGs.
5. The UCC has a target of 80% of patients being treated within 2 hours of arrival and this has been achieved every month to date in 2019. In addition, on the day before the Health Scrutiny meeting, 100% of patients were assessed and treated within the 2-hour target time.
6. The numbers of patients using the UCC is increasing and will continue to increase with more of the new housing on the old hospital site being occupied.
7. The hospital has achieved a Stage 6 in digital applications, one of the highest for a hospital trust. Some of the applications include electronic patient records, patient navigation and digital nurse call.
8. Electronic patient records ensure that only one copy exists, providing greater efficiency.
The following questions/issues were raised: -
In response to a question from Cllr Boztas, it was confirmed that the last
patient admitted to the UCC is at 9.00pm. Patients arriving after 9.00pm are re-directed to the Barndoc service, co-located with the UCC.
It was noted that the information on the website for Chase Side Hospital, relating to the access times of the UCC could be misleading. It was confirmed that this would be reviewed.
Cllr Neville asked whether, as the number of patients increases, are the reasons for attending tracked. The hospital is developing a strategy to encourage patients to use the most appropriate pathway, including the GP hubs.
Cllr Pite queried what proportion of patients make an inappropriate choice by visiting the UCC? In response, it is estimated that approximately 40% could make a GP appointment and wait to be seen.
Richard Gourlay commented that only 10-15% of patients presenting at North Middlesex Hospital A&E Department are admitted for further treatment.
This was emphasised by the Healthwatch Enfield Survey, undertaken at North Middlesex Hospital which highlighted that 89% of patients attending A&E were discharged to GP or self-care.
Members had attended a tour of the UCC and surgical wards earlier in the month. One of the issues raised was funding for changing dressings. Often, patients attend the UCC requesting that dressings are changed, however, although the service is provided, no funding is allocated from the CCG.
In response to a question from Cllr Pite on this subject, the CCG confirmed that dressings should be changed at GP surgeries or the GP hubs and they will work with the UCC to ensure the correct pathway is clear and well organised.
At the Bowes Ward Forum recently, comment was made that x-rays are not always available at the UCC. In response to a question from Cllr Brett it was confirmed that x-rays would always be taken in those cases when further treatment could be undertaken at the UCC. If the issue was more serious, for example a fractured hip, the patient would be transferred to another hospital where appropriate treatment (including x-rays) would be undertaken.
Natalie Forrest confirmed that 89% of patients attending the UCC are treated, with referrals made to A&E when only medically necessary.
Cllr Taylor commented that the recent tour of the new Chase Farm facility was very useful and offered his thanks. He further commented that patient transport/transfers between sites late at night can be problematic. In response, Natalie Forrest confirmed that hospital transport is operational 24 hours a day and patients should never be left stranded and they would be assisted home.
Cllr Pite noted that the patient transport service appears more efficient following the introduction of the electronic self-check system at Chase Farm. Patients are asked if they arrived at the hospital via hospital transport and if confirmed, the return journey is automatically generated.
Phlebotomy services were discussed and Cllr Boztas queried that as blood tests are no longer available at GP surgeries, what effect has this had on service provision at Chase Farm. Natalie Forrest confirmed that timed appointments could now be made at the hospital phlebotomy unit either in person, via a phone call or on-line. Children would receive blood tests in out-patient clinics. A problem with staffing numbers has resulted in delays in the appointment process but this is being addressed. Results are expected to be back with GPs within 1-2 days.
Natalie Forrest was thanked for the presentation and for organising the tour of the new facilities.