Centres of Excellence Update: Acute Medical Take

This programme of work, called Fit for the Future (FFTF), focused on strengthening eleven specialist services across our two main hospital sites: Cheltenham General Hospital (CGH) and Gloucestershire Royal Hospital (GRH). This would ensure that highly specialist care would be provided to more patients, waiting times would be lower, patient experience would be improved and patient outcomes would be better.

To support these improvements, the Trust secured more than £100m which has been invested in new buildings, state-of-the-art technology and equipment, new clinical practice, green initiatives, as well as digital care transformation across both sites.

As part these plans the Acute Medical Take will be centralised at GRH to improve patient care, outcomes and experience.

Why centralise the Acute Medical Take?

The Acute Medical Take is the process of coordinating medical assessments for patients to determine if they need hospital admission, can be seen by a specialist service or can return home after treatment in one of the walk-in units.

At present, if patients need a hospital stay, they may be admitted to an acute medical assessment bed or transferred to another specialist ward or department. This can involve patients being transferred between hospital sites to ensure they get to the team that can provide the right care and treatment.

By centralising the Acute Medical Take at Gloucestershire Royal Hospital (GRH) there will be several benefits, including:

• Patients are seen more quickly by the most appropriate specialist teams
• Patients experience more rapid diagnoses and shorter hospital stays
• Improved patient flow, shorter patient waiting times, and faster ambulance handover times
• Health outcomes and the overall patient experience are improved.

At Cheltenham Hospital this will lead to further improvements for patients, including:

• An improved Consultant-led Same Day Emergency Care (SDEC) service – which provides care for emergency patients who would otherwise be admitted to the hospital.
• New dedicated paramedic patient transport service between the hospitals.
• A larger specialist Hyper Acute Stroke Unit (HASU)
• Further development of specialist Urology services.

These benefits align with our ‘Centres of Excellence’ vision, where there is more planned care at CGH and a greater focus on urgent and emergency care at GRH. In doing so we will ensure that highly specialist care will be provided to more patients enabling us to improve patients’ outcomes, reduce waiting times, ensure more patients receive the right care, at the right time, in the right place, enhance safer staffing levels, attract and retain the very best staff and improve patient experience.

What does this mean for patients?

Cheltenham General Hospital will continue to provide a consultant-led Emergency Department (ED) from 8am-8pm and a nurse-led Minor Injuries and Illness Unit (MIIU) from 8pm - 8am, with an Intensive Care Service for critically unwell patients.

Patients who need to access urgent and emergency care can continue to do so as normal by calling NHS 111 (online or phone) or 999 (if it’s a life-threatening condition or serious injury). The local ASAP Glos NHS App and website has information on local services and when to use them.

For patients attending Cheltenham ED, there continue to be several options to provide the best care that is appropriate for them. These may include:

• Being seen, investigated and treated at CGH Emergency Department/MIIU
• Having an initial assessment in CGH Emergency Department/MIIU with treatment completed elsewhere - including:
  • Gloucestershire Royal Emergency Department
  • Another MIIU (Minor Injury and Illness Units)
  • A same-day emergency care (at Cheltenham or Gloucester)
  • Out of Hours GP
  • Directed to return to an outpatient clinic at a later date

Patients may be redirected to any of these options when they first arrive at the department by one of our nursing team if care needs may be better served by an alternate route.

Patients who present to Cheltenham ED will be managed in the usual way and admitted to an appropriate specialty ward. If required, they may be stabilised in general medical or surgical wards at CGH before transfer to the appropriate specialty ward.

When will this happen?

The Acute Medical Take is planned to be centralised at GRH from 23 July 2024. This is ahead of the junior doctors’ rotation in August giving us the time and capacity to embed new practices.

The Centres of Excellence at both our hospitals will ensure many more patients have better outcomes, reduced waiting times, and a better experience for staff and patients.