To ask the Scottish Government what the national support team it put at the Queen Elizabeth University Hospital to help improve performance against the four-hour A&E target identified as the key issues, and what actions have been progressed.
The key issues identified as hindering performance against the four hour A&E target at the Queen Elizabeth University Hospital (QEUH) were:
Bed management - how beds were made available quickly for patients requiring admission to avoid congestion and delay
Patient flow from the Immediate Assessment Unit (IAU) – how beds are made available quickly for patients
Infrastructure to support the delivery of services, e.g. portering services, room cleaning and pharmacy
The support team worked closely with the local team on site to implement key measures that would support immediate improvements and identified a number of next steps to ensure further improvement and sustainability, including:
Opening hours in the discharge lounge extended from 5pm to 8pm.
Rapid Response Team of domestic services formed to cut turnaround time from bed being vacated to being made available again – reduced turnaround time by over half (45 minutes to 20 minutes).
Additional porters deployed, including dedicated portering service to the discharge lounge, enabling the more timely transfer of patients.
The streaming of surgical patients directly from IAU to the Acute Receiving Unit to improve flow through the IAU, enabling belter communication and earlier specialist intervention
Prioritising appropriate discharge of patients pre-noon and at weekend and prompt turnaround and notification of bed availability across the site on more of a real time basis
The Scottish Ambulance Service is working closely with the hospital to ensure that crews are able to transfer patients as quickly and safely as possible, including scheduled weekly meetings with QEUH team
Staff at the QEUH continue to work hard and implement and enhance new ways of working, in line with the new six essential actions, to ensure that all patients are treated with the quality of care they deserve.
Performance at the QEUH averaged at 84.3% in June 2015. In the week-ending 16 August 2015 performance was 94.8%, an overall improvement of over 16 percentage points since week-ending 14 June 2015 (78.6%).
The transfer of services to the QEUH has been one of the largest and most complex ever undertaken anywhere in the UK. The support team found that the transfer delivered a range of improvements in service, including:
Imaging support for the emergency department which has been commended by staff.
Downstream in-patient specialty ward areas (medical and surgical) reported the ward environment as excellent for patients.
Team working in these wards was also reported as being well developed with visible clinical leadership.
Furthermore, throughout the transfer of the services the QEUH has maintained its excellent treatment time guarantee performance, including in paediatrics, it continues to see outpatients within the 12 week waiting time period and almost all patients requiring one of the key diagnostic tests are being seen within four weeks.
| Week Ending | 4 Hour Performance | 12 Hour Waits |
| 17-05-2015 | 87.9% | 0 |
| 24-05-2015 | 83.2% | 1 |
| 31-05-2015 | 83.2% | 1 |
| 07-06-2015 | 78.3% | 8 |
| 14-06-2015 | 78.6% | 0 |
| 21-06-2015 | 89.6% | 0 |
| 28-06-2015 | 88.6% | 0 |
| 05-07-2015 | 94.0% | 0 |
| 12-07-2015 | 93.5% | 0 |
| 19-07-2015 | 92.6% | 0 |
| 26-07-2015 | 88.6% | 0 |
| 02-08-2015 | 93.8% | 0 |
| 09-08-2015 | 92.7% | 1 |
| 16-08-2015 | 94.8% | 0 |