WINNER - A Partnership Project: Welsh Ambulance Service Trust (WAST) – NHS Same Day Emergency Care (SDEC) Pilot

Hywel Dda University Health Board

The impact of extensive ambulance handover delays, lost ambulance hours (878 hours in April 2022) and longer waiting times for people waiting to be seen in the Emergency Department (ED) prompted the need for improvement and the need to avoid unnecessary attendances to ED. Local data indicates that the longer a person waits in the ED, the more likely they are to be admitted and the longer their hospital stay.

It was recognised that there was no direct Welsh Ambulance Service Trust (WAST) admission pathway into Same Day Emergency Care (SDEC), which impacted on delays, and there were increased concerns and incidents due to overcrowding in the ED, potentially impacting on patient outcomes including patient experience and quality of care.

It was decided to create a direct access pathway for WAST to SDEC that is accessible 09:00 – 19:00 seven days. A pilot was commenced at Withybush General Hospital, Pembrokeshire, which included additional SDEC staff resourcing with an SDEC Co-ordinator, staffed by the SDEC nurse manager and an additional registered Band 5 nurse. An extended clinical area, including trolley bay, was also provided to enable rapid transfer and timely handovers from WAST paramedics to SDEC staff.

The data collated so far has evidenced that the average SDEC handover time is 8 minutes versus 1 hour 26 minutes in Emergency Department (ED). There has been a reduction in handover time releasing 34:48 hours of capacity, equating to around 3 crews of 11.5 hour shifts, and avoiding WAST conveyance has saved 10:03 hours which equates to 1 crew.

Since the pilot launch on the 9th May, there is a reduction in the proportion of new non-elective presentations at Withybush Hospital who go on to be admitted for at least one night, despite an overall increase in attendances.

Janice Cole-Williams

janice.cole-williams@wales.nhs.uk