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Unscheduled care

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Unscheduled Care is medical help that is not expected. It includes emergency care.

This page contains information about all the departments that help people who need unscheduled care.

What is unscheduled care?

We determine unscheduled care to be any contact with the NHS by a person needing assistance or seeking help, care or advice that is unplanned or outside of normal daytime hours.

See below for the departments we currently run that deal with unscheduled care patients.

Our support services

The Imaging Department at the Royal Liverpool and Broadgreen University Hospitals NHS Trust carries out more than 200,000 examinations per year across three sites.

Facilities are state-of-the art including five X Ray rooms, two fluoroscopy rooms, four CT scanners, two MR scanners, five ultrasound rooms at Liverpool Royal and four at Broadgreen, and a four-roomed intervention suite.

Both radiology and vascular surgery in angioplasty are carried out in a new hybrid theatre. The Department has an ever-growing reputation for ground-breaking work in intervention. The best available resources are in place to enable three types of endovascular aortic repair – EVAR, fEVAR and bEVAR.

Radiographers trained at The Royal are equipped after two years to specialise in Plain Film Radiography, Emergency Department Radiography or Dental Radiography.

The work in Imaging is wide and varied, with some radiographers reporting and others carrying out biopsies in ultrasound or joint inspections for musculoskeletal analysis.

Key posts include a research radiographer, a radiographer in gastro-intestinal reporting and examination, and a radiographer in the intervention field who carries out liver biopsies.

The Imaging Department, which has recently received a “good” commendation from the Care Quality Commission, hosts a Cardiac Computed Tomography (CT) training course annually. There is an extensive induction package for all radiographers either cross-sectional or plain film

The Pharmacy Department leads the Trust Medicines Management agenda and provides a complete service to the whole Trust. It is committed to providing high quality pharmaceutical care by ensuring cost effective purchasing, distribution and use of medicines.

During the week, up to sixteen outpatient clinics operate at any one time providing services for over 300,000 outpatients per year. The pharmacy works in partnership with Lloyds Pharmacy to dispense outpatient prescriptions. The prescriptions are dispensed from a separate retail outlet in the hospital complex.

Patients have shorter waiting times for their prescriptions whilst having access to the same high quality pharmacy advice as they had previously. The department shares two joint teacher/practitioner pharmacist posts with John and there are three posts each year for training new graduate pharmacists in hospital pharmacy.

Each year (on average), two pharmacists complete further education qualifications such as a Clinical Diploma or Msc and a number of ‘in-house’ education programmes exist for in-service training of pharmacy staff.

A number of the pharmacy staff have NVQ assessor award qualifications and internal verifier accreditation. Meanwhile, senior pharmacy staff have taken part in national pilot schemes for NVQ levels 4 and 5 management awards. The department also has long-standing links with the school of Pharmacy and Chemistry, Liverpool John Moores University.

As well as using their courses, it also employs two lecturer practitioners who are employed on a 50:50 and 75:25 split (Hospital: University). A number of departmental staff also lecture there on a regular basis, depending on the academic calendar and curriculum

Emergency Department

The Royal’s Acute Medical Unit’s (AMU) is one of the largest in the country with its own direct access. It provides a facility that allows medical staff to assess, evaluate and treat patients with a wide range of acute medical problems and conditions in a purpose built clinical area.

The Unit sees on average around 450 patients per week and 98 per cent of all medical patients admitted through the Trust are assessed through this facility.

Patients are prioritised using a combination of Manchester triage guidelines and a medical early warning system (MEWS) thus ensuring that most urgent cases are seen first.

Afterwards, rapid access to routine investigations results in over 30 per cent of patients being discharged – averting unnecessary admissions.

The Unit is also proud of its record of discharging a further 39 per cent of patients within 12 hours and 71 per cent of patients within 24 hours.

Read more about the Emergency Department here

The Emergency Department at the Royal is the biggest and busiest in Merseyside. The aim is to see patients as quickly as possible and over the last few years has treated, discharged or admitted over 95 per cent of patients within four hours (the national target).

All patients that come to the Emergency Department will be seen and assessed by a qualified member of the nursing team, subject to a national set of assessment guidelines, a decision will be made as to which area of the department will best suit clinical needs.

The Department has also been awarded an outstanding result from the Care Quality Commission who visited the department to look at our policies and protocols in relation to child protection.

The department also works closely with vulnerable adults and the homeless and has received awards at both a trust (Team of the Year) and national level (Nursing Times Accident and Emergency Nursing award).

Read more about the Emergency Department here

Anyone arriving at the A&E department with a surgical need, or who is referred by their GP, is initially evaluated at the Emergency Surgical Assessment Unit.

Quaified nurses will assess every patient’s requirments on a case-by-case basis before treatment takes place.

Majors who are admitted to the Emergency Surgical Assessment Unit (ESAU) tends to see most chest pains, abdominal pains, significant fractures overdoses and there are twelve cubicles and four high dependency cubicles which are located immediately opposite the main nursing station.

Minors tends to see the walking wounded, cuts, limb fractures, muscular/sports injuries. In addition, there is a dedicated plaster room and abscess cubicle where minor surgical procedures are performed. There are two designated suture rooms where wounds are closed and treated wounds.

Read more about the Emergency Department here

Palliative Care

The Palliative Care team provides a consultancy, 7 days a week, Specialist Palliative Care service for patients and carers, by:

  • advising on pain and symptom control, facilitating spiritual and social support and providing psychological and bereavement care
  • empowering health professionals to provide evidence based palliative care through education, research and audit.
  • collaborating with health providers across clinical settings enabling national and local and national policy development in pursuit of a seamless palliative care service.

It also supports a clinical base for the Marie Curie Palliative Care Institute Liverpool (MCPCIL). The Institute aims to be an international leader, a collaborative partner, and a centre of research excellence for care of the dying.

It also aims to facilitate and support those who want to make a local, national or international difference to drive up quality for care of the dying.

The Directorate supports an out patient service at the Trust in collaboration with the Hospice and Community colleagues. Every week all out patient requests are reviewed and appointments offered at the earliest opportunity in the location most appropriate for the patient.

Find out more about palliative care here

Urinary Tract

The Nephrology Unit provides care for patients with Chronic Kidney Disease.

The unit has an extensive dialysis programme that includes home and hospital dialysis therapies It is run by a dedicated team of health care professionals who provide the highest standard of care and support to all their patients.

The unit cares for people with Chronic Kidney Disease as inpatients and outpatients. It has the largest dialysis programme in the Merseyside region with more than 400 patients “on its books”.

The Department serves a population of about 1.2 million people throughout Liverpool and its suburbs including North Cheshire. Satellite Haemodialysis units are located at Broadgreen, Warrington, Halton and St Helens.

Learn more about Nephrology here

The service based in Broadgreen Hospital provides general urological care to the local population, as well as specialist care to the people of Merseyside. It is a large department with nine consultant urologists and five specialist nurses.

There is a purpose-built urology centre at Broadgreen, containing all the outpatient facilities and the lithotripsy and a urodynamics suites. All planned surgery is provided at Broadgreen Hospital and emergency care is provided at the Royal Liverpool University Hospital.

The outpatient department is based at Urology Centre. It was purpose-built in 2006 to house an expanding Urology service. It houses a Urodynamic suite, and fixed treatment of kidney stones, dedicated radiographers to carry out ultrasound and other tests, and numerous clinical rooms where outpatients can be assessed and treated.

In addition, the Specialist Nurses are based here. In 2011, 4200 new patients and 7500 follow-up patients were seen in the Urology Centre.

The department provides a kidney transplantation service for patients in Merseyside, North Wales and the Isle of Mann. Last year, staff carried out a recordbreaking 101 transplants.

The Liverpool Transplant Unit mirrors the Trust vision of being a World Class Service and is recognised as the service of choice for the people of Merseyside, Cheshire, North Wales and beyond.

The objective is to ensure the services matches demand in an environment that is suitable to ensure safe, efficient and effective patient care. Since 1969, The Sir Peter Medawar Unit has carried out over 2,500 kidney transplants at The Royal Liverpool University Hospital.

Surgeons work side-by-side with specially trained transplant medical staff including Nephrologists, Immunologists, Infectious Disease Specialists, Anaesthetists, and Cardiologists who together, provide unmatched expertise before and after a transplant.

The dedicated team also includes Clinicians, Specialist Nurses, Staff Nurses, Healthcare Assistants, Pharmacist, Dietician, Social Workers and Administration Staff who solely work with transplant patients.

The service aims to: 

  • provide excellent pre and post kidney transplant care to patients
  • maintain academic excellence in clinical transplant research
  • provide transplant training to medical students, residents and Nephrology fellows
  • promote organ donation
  • work with partners in the community to foster greater understanding of transplantation, its benefits and its outcomes.
  • work within the greater national and international transplant community to improve the quality of life for transplant patients.

Find out more about renal transplants here

Medicine

The Respiratory Unit at the Royal Liverpool University ad Broadgreen University Hospital comprises of two wards and an enhanced care unit.

The department, in liaison with the cardio-respiratory and radiology departments, provides a very wide range of diagnostic tests and treatments for all types of chest and lung disorders.

In 2010 a dedicated unit opened to provides a rapid access Non-Invasive Positive Pressure Ventilation Service (NIV) for patients with respiratory acidosis, in a dedicated setting.

This unit was specifically designed to ensure patients are observed at all times by highly skilled nursing staff. The NIV unit includes wards 6X, 6Y (49 beds in total) and a four bedded enhanced care area for patients requiring a higher level of care.

It provides high quality care for patients with respiratory failure and a large number of long term respiratory conditions. The unit specialises in chronic disease management as well as acute treatment, such as asthma, bronchiectasis, Chronic Obstructive Pulmonary Disease (COPD) and lung cancer.

The team prides itself on having close working relations with colleagues within the ITU and palliative care departments and a number of its consultants also work in Liverpool Heart and Chest Hospital.

Find out more about the Respiratory Department here

Highly quality care provided in a timely manner and catered to individual needs is the primary aim of the Diabetes Team.

A multidisciplinary approach is adopted by the team, which includes five consultant physicians who specialise in diabetes, endocrinology and general medicine.

There are also two diabetes and endocrinology wards and seven diabetes specialist nurses providing care to diabetic and endocrinology patients.

Dieticians, podiatrists a bio-medical scientist and clerical staff, including medical secretaries also work together to ensure patients’ conditions are managed and their health is improved.

Find out more about Diabetes and Endocrinology here

 

The LCSH is committed to providing a high quality service to people worried about issues affecting their sexual health.

Staff who come to work at the centre will specialise in the management and care of people who may be worried about issues affecting their sexual health.

Departmental staff also have to understand the concerns and anxieties patients may have about visiting a clinic. They are also trained in being supportive and understanding and always treating people with the dignity and respect that they deserve.

This Consultant run service offers:

  • sexual health advice and information
  • clinical examination and treatment for sexually transmitted infections
  • rapid laboratory diagnosis
  • HIV testing
  • care and management of patients with HIV infection
  • cytology
  • contraception including pills, implants, coils (IUD’s), emergency contraception, pregnancy testing and condoms.

Specialist services include:

  • vulval clinic
  • outreach service run by nurses for young people at Liverpool Brook (Tuesdays and Thursdays)
  • HIV clinics

Find out more about LCSH here

The department looks after patients with general infections from the community and healthcare settings including pneumonia, skin and soft tissue infections and gastroenteritis (diarrhoea and vomiting).

In addition , the expert team look after more uncommon infections such as measles, bone and joint infections, Tuberculosis (TB) and HIV as well as infections and illnesses contracted during travel to tropical regions such as malaria.

The regional adult unit for tropical and infectious diseases (TIDU) based at the Royal offers a wide variety of inpatient and outpatient services, in close collaboration with other units involved in the management of different infections.

The department works with a number of other hospital trusts to ensure that the latest medicines are in place and regulations in place in case of an outbreak.

There are particularly close links with the Liverpool School of Tropical Medicine (LSTM) and most of the clinicians in the LSTM also work in the TIDU. TIDU and LSTM clinicians also work with the Department of Clinical Pharmacology, based primarily on Ward 3B. HIV care is shared with clinicians of the Liverpool Sexual Health Centre (also known as GUM) and community based practitioners.

Find out more about Infectious Diseases here