Patients to be screened before access to Horton A&E

Health bosses are hoping to be given £1.5m of extra money to build an extension to the Accident and Emergency entrance where patients will see GPs beforegoing in to the hospital.

Oxfordshire Clinical Commissioning Group’s (OCCG) aim is to help A&E meet its targets of seeing 95 per cent of patients within four hours.

Diane Hedges of the OCCG told a meeting of the Community Partnership Network (the Banburyshire health services stakeholders’ committee) the ‘Integrated Front Door’ would consist of GPs, nurses, the Out of Hours (OOH) service and the Horton’s own A&E.

“We have the Out of Hours service that runs within the Horton Hospital but it’s not directly linked into the Emergency Department (ED). People get redirected to the OOH which is not in the best environment,” said Ms Hedges.

“More recently we’ve had better performance in relation to the four hour standard but the Horton has been challenged in terms of its ability to see people within four hours so we need to consolidate the thinking we have around how we manage Out of Hours primary care presentations and how we manage people presenting for usual A&E.

“One of the requirements some time ago was for us to have GP screening in every ED and we don’t have GP screening in the Horton,” she said.

“Now we have the opportunity to look at how we can bring together the GP elements, the OOH elements and the Emergency Department and that’s why we’re calling it an Integrated Front Door approach.”

Ms Hedges said evidence shows Banbury has a much higher proportion of people going to A&E than Oxford city.

“We need to make sure, when we look at the nature of those presentations, (whether) they are more likely to be the sort of things that don’t get treatment or are the sorts of treatments that lend themselves to support from primary care,” she said.

“People are potentially turning up at ED and seen by a consultant when it would be better for them to be seen holistically by general practice.

“So we’re looking to how we can wrap those things together – our OOH, our GPs and our ED and place all of that at the front door of the Horton thereby leading patients to get the most appropriate care.”

Ms Hedges said patients who did not need full A&E care would be assessed by the primary care unit at the front door and guided back to their own GP practices.

She said discussions had taken place between all parties to find out how to get the best professionals involved.

“It is an exciting initiative, very much about consolidating ED performance and making sure we can get four-hour performance – more than 95 per cent of patients seen within four hours,” said Ms Hedges.

She said the system had been suffering from gaps in OOH rotas and explained this solution would allow patients to be seen by the right clinician in the most appropriate place.

“We’ve bid for funds. We haven’t heard (the outcome) but we bid for £1.5m to reshape that front door so we can get primary care support alongside the ED,” she told the meeting.

Some members of CPN said they thought there should be more education in schools and the community about proper use of the NHS.