A day in the life of ED

Our emergency department (ED) team recently had the valuable opportunity to work with colleagues across the healthcare system to explore new and adapted ways of working to improve the service they provide to our patients.

On Thursday, 22 April, we invited representatives from across our system partner organisations to join us for a focused day of meeting with and shadowing our ED team. This gave our partners an insight into the busy and varied work of our ED team, with regular touchpoints throughout the day to share observations, feedback and suggestions.

The team were joined by partners including: y Essex Partnership

University NHS Foundation

Trust (EPUT) y The East of England

Ambulance Service NHS

Trust (EEAST) y Essex County Council (ECC) y West Essex Clinical

Commissioning Group (WECCG) y East and North

Hertfordshire Clinical

Commissioning Group (E&NHCCG) y NHS England and NHS

Improvement

Thank you in particular to Louise Hall, deputy director of transformation, West Essex CCG, and Paul Cleeland-Smith, head of UEC operations, NHS Improvement, who were instrumental in arranging the day.

The questions to guide conversation on the day were: y How does it feel to work in our ED team? y What is the ED experience like for our patients? y Did the patient meet the criteria for a specialist

ED department or Urgent

Treatment Centre (UTC)? y What community alternatives could have been offered to avoid an

ED attendance or UTC appointment? y What opportunities are there for improvement in community or hospital pathways?

During the day, we saw patient numbers increase from 29 in ED at 8.30am to 100 by 5.30pm, giving an insight into the fast-paced environment.

Key themes highlighted included the challenges of: y The COVID-19 pandemic y Working across the county borders (Essex/

Hertfordshire) It was noted that: y Effective communication between organisations is vital y Patients attending often do not meet the criteria for either ED or the urgent treatment centre. y There are high fluctuations in activity y Processes can be strengthened to support our patients and people y Opportunities are available with a focus on additional data y More guidance can be given to patients on accessing NHS 111 or their

GP surgery y We can carry out work to further integrate NHS 111 pathways y We can review our systems to support booking into a more appropriate service for patients y We can offer further training to our teams on available community pathways y We can review our referral pathways to partner organisations