Easy Read Information
This page has information about the quality of our work. It also has information about how long patients have to wait before being seen.
Along with other NHS Trusts, we have a range of different targets relating to infections, waiting times and other measures. You can read more about these here
Treating emergency patients
Tin 2016-17 89% of patients requiring treatment for an accident or emergency were admitted, transferred or discharged within four hours of arrival. Whilst this is below the national standard of 95% or patients, it is in line with other comparable trusts across the country. In 2016-17, there were over 91,500 attendances to the emergency department at the Royal. This is around 7,600 a month, 1,700 a week, 250 a day.
Like other hospitals, we have seen an increase in emergency attendances and patients who need admitting to a hospital bed from the emergency department. In 2016-17, a quarter of people attending the Royal’s emergency departments (including St Paul’s Eye Clinic) were admitted to hospital. Among those requiring admission 46% were aged 65 or over. These patients tend to be more unwell and often require more complex care, treatment and various tests. They also often require complex care and support in the community once they are discharged. This has a significant impact on the flow of patients through the hospital resulting in increased pressure on the emergency department.
Patient flow improvements
Like many hospitals across the country, the Trust faced significant challenges in meeting high demand and achieving a smooth flow of patients through the hospital. Frequently throughout the year there have been over 100 patients in hospital beds who were ready to be discharged. The majority have been waiting for care packages in the community to support their discharge and have had to remain in hospital despite being medically fit to leave. By working across teams within the Trust and closely with local partners in health and community care, a number of improvement projects have been introduced to improve patient flow.
During the year, we have worked to minimise the number of cancelled operations on the day of surgery for non-clinical reasons, and to ensure that if an operation has to be cancelled, our patients are given a new date which is within 28 days from their original date. However, an increase in emergency admissions throughout the year means that we have cancelled more operations than we would like. This year we had to cancel 398 operations, which is 0.69% of our total operations carried out.
We narrowly missed the national standard of ensuring patients are treated within a maximum of 18 weeks from their referral. 90% of patients were waiting less than 18 weeks against a target of 92%. We have seen a substantial increase in our activity, particularly with urgent procedures and have experienced staff sickness within our surgical teams. We have also undertaken a transfer of regional upper GI surgery from other local trusts that has increased demands on services. Later in the year, national industrial action also impacted on our ability to ensure at least 92% of patients would receive their treatment within 18 weeks of referral. We are recruiting more surgeons and anaesthetists and are working with local partners to share capacity across the health economy.