Emergency Department (ED) Interface

A new, community-care based model – the ED Interface – is being proposed to help relieve pressures on Sunderland Royal’s emergency department.

The model suggests that services currently being delivered by Recovery at Home with the addition of GP services and other specialist teams (from either the community or the Trust) would provide an important triage for people arriving at hospital without an appointment.

Core the effectiveness of the process is the ‘Trusted Assessor’. This role will be fulfilled by a clinical lead – usually a GP; but it could be a community nurse or one of the hospital’s specialist medical team.

Together with the whole ED Interface team, the Trusted Assessor will identify the most effective level of care someone needs and stream them to the right service. This could include referral back to their own GP or another community-based service or into the more specialised services provided by the emergency department.

Work is in progress to deliver the service fully this summer. All Together Better, City Hospitals Sunderland and the CCG are working collaboratively with local GPs on important elements such as clinical pathways to make sure local people get an improved care right in the centre of the city.

As well as releasing pressure on hospital staff, there is potential for community patient transport to take people who need it to other treatment centres or home if they don’t need on site treatment.

Paramedic Pathfinders

The ED Interface project is also supporting an expansion of training on the Paramedic Pathfinders pilot scheme, delivered by North East Ambulance Service (NEAS).

The scheme is providing a seamless link between a range of community-based services and paramedic clinicians, as an alternative to taking a patient to A&E.

Since the pilot began in September, 2016 instead of being taken to A&E 815 people have been successfully referred to alternative care providers in Sunderland, including: Recovery at Home GPs, Urgent Care Centres, The Recovery at Home Team, The Palliative Care Team and The Emergency Ambulatory Care Unit at Sunderland Royal Hospital.

Pathfinder involved the training of around 100 NEAS ambulance clinicians to use a grounding-breaking clinical triage tool for patient assessments. The pathfinder triage tool works by enabling clinicians to recognise symptoms rather than the need to make a definitive diagnosis. Ambulance clinicians work from the top of the Paramedic Pathfinder flow chart to the bottom and must eliminate all other possibilities before going onto the next step. This helps them make extremely accurate face-to-face patient assessments and confidently choose the most suitable place for treatment.

As well as improving the patient’s experience by providing care tailored exactly to their needs, Pathfinder is helping to significantly reduce the load on Sunderland’s A&E departments with a view to the service being further embedded at a regional level to get the most benefit.