Seven days NHS Service delivery: it is possible even in a geographically challenged district general hospital The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust Poster from the 'Delivering NHS services, seven days a week' event held in Birmingham on 16 November 2013 More information about this event can be found at http://www.nhsiq.nhs.uk/news-events/events/nhs-services-seven-days-a-week.aspx

1.
7days
NHS
Service
Delivery:
it
is
possible
even
in
a
geographically
challenged
DGH
Dr
Raj
Shekhar,
Dr
Umesh
Rai,
Dr
James
Phillips,
Sr
Di
Benefer,
P
Williams,
Ann-­‐Marie
Hurst
&
Cursty
Pepper
on
behalf
of
QEH
Specialist
Stroke
Team
Our
stroke
services
have
transformed
over
the
last
five
years
from
one
being
recognised
only
by
a
rehabilitation
unit
in
one
corner
of
the
hospital
to
the
highly
skilled
multi-­‐professional
team
delivered
hyperacute
stroke
unit,
excellent
specialist
stroke
rehabilitation
service
and
easily
accessible
stroke
prevention
clinic.
Percentage
of
people
spending
90%
of
their
inpatient
time
in
stroke
unit
increased
form
20%
to
85%.
Significant
reduction
in
length
of
stay
from
over
30days
five
years
ago
to
less
than
11
days
–
results
of
7days
Consultant
input
+
w/e
therapy
Equity
of
care
7
days
a
week
Increasing
proportion
of
patients
having
better
care
and
significant
reduction
in
in
hospital
mortality
Percentage
of
stroke
inpatients
thrombolysed
between
April
2011-­‐
March
2012
QEHKL
=
10.5%
(National
median
=
6.7%)
Even
though
discussions
were
ongoing
the
turning
point
for
7
days
a
week
TIA
service
Waiting
time
to
assess
high-­‐
risk
patients
dropped
from
60
days
in
2008
to
only
few
hours
Significantly
reduction
in
A/E
footprint
and
medical
admissions.
change
came
when
a
patient
summed
up
the
then
existing
service
like
-­‐
’’it
is
not
acceptable
to
have
a
very
high
level
of
care
only
during
working
hours
and
much
lower
level
of
care
at
evenings
and
weekends
despite
the
honest
fact
that
health
care
needs
are
similar
for
a
particular
condition
e.g.
stroke.
One
cannot
predict
timing
of
stroke;
hence
provision
for
best
care
should
be
available
all
the
time’’.
How
did
we
do
it
:
• Seven
days
a
week
Consultant
review
for
stroke
patients
• Weekend
stroke
specialist
therapy
sessions
• Weekend
diagnostic
services
following
successful
training
of
consultant
radiologists
• Engagement
from
primary
care/GPs
and
other
users
following
awareness
sessions
• Direct
admission
of
suspected
stroke
patients
to
the
stroke
unit/assessment
area
• Out-­‐of-­‐hours
consultant
decision
making
for
acute
treatment
using
innovative
telemedicine
• Patient
awareness
program
linked
with
Stroke
Association
UK
• Guidance
and
visionary
leadership
skills
of
the
lead
clinician