NHS Trolley Waiting times – to what extent does this issue impact on local people?

Healthwatch East Sussex wanted to find out to what extent the national issue of NHS Trolley waiting times effects people in East Sussex. They spoke to 75 people and visited the A&E department at Eastbourne District Hospital.

The doors to A and E, previously used by ambulance staff, have been broken for several weeks. Whilst some staff felt this did not have an impact on access to the hospital, it does result in everyone accessing A and E using the same entrance. It would be more efficient if the doors were mended. This needs to be investigated. 

Some hospital staff were observed to be more effective in speeding up the discharge of patients to other areas of the hospital or from the hospital. It is uncertain why this is the case. However, this needs to be explored in order that any good practice from one set of staff can be passed onto other staff. 

One factor in a delay in patients waiting in treatment bays is the length of time it can take for blood samples to get to pathology and potential delays in getting the results back. This can be due to pressure on the A and E porter, who may be doing other areas of work, and a lack of the hydraulic chute being used. There were examples of the A and E porter being very busy, but porters being in the porters lodge waiting for work to be allocated to them. There are conflicting views as to why the chute is not used and its impact on blood samples. 

Actions that need to be considered: 

• The portering system needs to be reviewed, to ensure there is best use of resources. Potentially, this could include ensuring that A and E is given priority or that two porters are allocated to A and E at pressure times. This could improve the time it takes to take blood samples to pathology, but also reduce delay in taking patients to such areas as X ray and CT scan.
• The issues of the hydraulic chute needs to be investigated as potentially, if used, this would speed up the process of getting samples to the pathology department. The investigation needs to include whether A and E is in the section that is more unreliable.
• There is the possibility of blood samples dropping behind the tray that is below the post box in pathology. It is not clear why the tray is there, unless it is used to carry all the samples to the right area in the pathology department. If it is the latter, then the tray serves no purpose for ‘catching’ the samples and could be removed, to avoid any possibility of samples dropping behind it. 

 It is good that the system, for alerting A and E staff that the blood and other sample results are available, is to be improved. This could have an impact on treatment times. 

The reported delay in arranging for a deep clean of treatment bays needs to be investigated. 

A number of issues were identified that were not related to trolley waits. However, these also need to be investigated, especially the issues related to infection control. 

It was good to note the good and positive working relationship between ambulance staff and hospital staff.

It was good to observe that no patients were kept in ambulances, but came straight into the hospital. It was also good to note that, generally, there was not a long wait before patients were taken into a treatment bay