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North Cumbria University Hospitals NHS Trust - 70 years of the NHS


Home > News > Delivering the right care at the right time in the right place

Delivering the right care at the right time in the right place

Posted on Tuesday 28th August 2012
medical model first day

Dr Fiona Dallas on her first day on the Emergency Assessment Unit

Medical staff in the Emergency Assessment Unit at Carlisle’s Cumberland Infirmary have started working in a new way which is significantly improving the delivery of emergency care to patients in north Cumbria.

From 1 August, two new full-time acute physicians have been permanently based on the Emergency Assessment Unit (EAU) who are assessing and reviewing patients as they are admitted. It replaces a previous on-call system with a more modern approach to acute care, in line with national best practice

Patients are referred to the EAU either directly by a GP or via the hospital Accident and Emergency Department and this is where a pathway of care is developed for them. Patients can either be admitted to the hospital, issued with treatment or discharged following an assessment of their care needs on the EAU.

Previously patients may have had to wait for some considerable time, either on the EAU or in A & E before this assessment took place. Now they are seen by senior decision makers on the ward and medical plans are established quickly to eliminate un-necessary waiting.

The new Medical Model on EAU is part of a wider emergency flow project which has the input from all healthcare sector organisations across north Cumbria, including GPs and is aiming to improve the way local hospitals handle emergency admissions. This is to ensure that patients are seen in a timely way and that their care is delivered in the right place and in the right way.

Dr Fiona Dallas is the lead clinician on the EAU and said: “The full-time presence of an acute physician means it is much easier to get an overview of a patient and to plan the care they need as quickly as possible.

“I believe this new way of working will also be more rewarding for the staff working on the unit and should enhance their ability to deliver the right care at the right time. It has also come just as we have taken our allocation of new junior doctors so this will also enhance their training.”

The changes to the admissions process have already demonstrated positive results. Although emergency admissions to the hospital have been high in the last few months, 98% of patients have now been seen within the four-hour waiting time in A & E since the new system came into place four weeks ago.

There has also been a 90% reduction in the number of patients referred by GPs waiting to be seen in A & E.

From 8am to 6pm, Monday to Friday, an Acute Physician will be present on the EAU and there will be Consultant Physician present on both Saturdays and Sundays, 8am to 2pm, ensuring patients are reviewed over the weekend.

There have a number of changes introduced recently as part of the Emergency Flow Project, designed to make it easier for staff to deliver high quality care. The next step in the project will involve working more intensively in the A&E department and working closely with our partners (Cumbria Partnership Foundation Trust, NHS Cumbria, Cumbria Health on Call and the new Clinical Commissioning Group) in order to improve care for urgent health and social care needs.

The new way of working in the Emergency Assessment Unit will be launched in West Cumberland Hospital in Whitehaven on 12 September 2012.