As part of its plans to tackle corridor care, the government has named the locations for 40 new and expanded same-day emergency centres (SDEC) and urgent treatment centres (UTCs) across England.
The programme, backed by £215.5 million, includes 10 new urgent treatment centres (UTCs), four expanded UTCs, five new same day emergency care (SDEC) services and 21 expanded SDECs, providing a significant increase in frontline capacity. This will help ease pressure on A&E departments by ensuring more patients are treated in the right setting, reducing waiting times and improving patient flow through hospitals to tackle corridor care.
The new centres are part of a wider programme to provide specialised and tailored support to Trusts with the highest levels of corridor care, to eradicate this practice by the end of this Parliament. Expert teams are being deployed to the most affected hospitals, providing bespoke clinical support to leadership staff, as early data shows the majority of corridor care is concentrated in a small number of NHS Trusts.
Some of the new and expanded services will open later this year, further strengthening NHS capacity ahead of the winter.
Specialist support
The Getting it Right First Time (GIRFT) team are supporting leaders to learn from NHS Trusts which have already made significant inroads into reducing corridor care this year. The specialist GIRFT teams provide tailored support to each hospital – including identifying how to improve discharge and flow, helping Trusts to better understand their own data so they can improve predicting when surges in demand may appear and supporting clinical leaders in improved decision making.
Last month (March), NHS England published a clear definition of corridor care for the first time. This will allow Trusts to begin collecting data, which will be published from May. It has also outlined its ‘model emergency department’ – a blueprint for how services should operate from this year. This will involve more assessments and triage by senior clinicians earlier, allowing patients to be cared for away from busy A&Es where appropriate.
Health and Social Care Secretary Wes Streeting describes the corridor care as “unacceptable” and “undignified,” saying “for too long, the normalisation of corridor care has been baked into our NHS.” However, he believes there are “green shoots of recovery.”
As an example, at Queen’s Hospital in Romford, the introduction of a new initial assessment process has reduced waiting times by 37 minutes and increased access to a senior decision maker to ensure patients are being seen in the right place. The frailty Same Day Emergency Care Centre is also helping reduce the number of older patients being cared for in corridors, with multi-disciplinary teams focused on offering rapid, comprehensive assessment and intensive support so patients leave hospital as quickly and safely as possible.
Positive examples
The GIRFT team are making progress in emergency departments across the country, identifying the issues creating blockages and acting swiftly to rectify them:
• Hull: reduced ambulance handover delays by 27% and cut 12-hour waits by 47% - both of which have contributed to patients needing to spend less time on corridors and being treated more quickly. Ambulance colleagues were key to enabling this reduction in delays working closely with their A&E partners to ensure patients were getting the right care when needed.
• Royal Blackburn (East Lancs): the main corridor has been cleared of patients, with an 18% reduction in 12-hour waits. A key part of this successful approach was senior leaders including Medical Director and Chief Nurse taking responsibility over how to prioritise those patients who should be discharged home so that patients in A&E who needed hospital care could be moved onto wards.
• Blackpool: significant inroads to tackle corridor care have been made, with a 43% cut in 12-hour waits and reductions in the patient’s length of stay and those waiting for discharge. This was achieved by executive members of the Trust being present on the A&E floor, better use of data to predict busiest periods allowing staff to prepare, alongside a new admission process through a 24-hour Medical Assessment Unit with patients avoiding A&E entirely.
Professor Tim Briggs, NHS England’s national director for clinical improvement, elective and UEC recovery, and Chair of the GIRFT programme, says: “We’re working hard to support the Trusts facing the biggest challenges with patient flow and we’re seeing some good early evidence of reductions in corridor care for patients.
“We have worked alongside these Trusts to produce guidance and standards, as well as providing hands-on support, which will help them significantly reduce corridor care. Our focus over the next six months is to take what we’ve learned and cascade it across the whole NHS, so we can improve care for patients and eliminate this issue once and for all.”
New and expanded UTCs and SDECs
New UTCs:
• Heartlands Hospital, University Hospitals Birmingham NHS FT
• Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS FT
• Good Hope Hospital, University Hospitals Birmingham NHS FT
• Salisbury District Hospital, Salisbury NHS FT
• Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust
• Northampton General Hospital, Northampton General Hospital NHS Trust
• The Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust
• North Middlesex Hospital, Royal Free London NHS FT
• Southampton General Hospital, University Hospital Southampton NHS FT
• Royal Hampshire County Hospital, Hampshire Hospitals NHS FT
Expanded UTCs:
• Stepping Hill Hospital, Stockport NHS FT
• Dorset County Hospital, Dorset County Hospital NHS FT
• Queen’s Medical Centre, Nottingham University Hospitals NHS Trust
• Queen Elizabeth The Queen Mother Hospital, East Kent Hospitals University NHS FT
New SDECs:
• Barnsley District General Hospital, Barnsley Hospital NHS FT
• Alder Hey Children’s NHS FT
• Queen Elizabeth The Queen Mother Hospital, East Kent Hospitals University NHS FT
• Royal Surrey County Hospital, Royal Surrey County Hospital NHS FT
• Southampton General Hospital, University Hospital Southampton NHS FT
Expanded SDECs:
• Charing Cross Hospital, Imperial College Healthcare NHS Trust
• West Middlesex University Hospital, Chelsea and Westminster Hospital NHS FT
• West Middlesex University Hospital, Chelsea and Westminster Hospital NHS FT
• Lincoln County Hospital, United Lincolnshire Hospitals NHS Trust
• Cumberland Infirmary, North Cumbria Integrated Care NHS FT
• Doncaster Royal Infirmary, Doncaster and Bassetlaw Teaching Hospitals NHS FT
• Harrogate District Hospital, Harrogate and District NHS FT
• Bryn Ward, Wrightington, Wigan and Leigh NHS FT
• Abingdon Community Hospital, Oxford Health NHS FT
• Wexham Park Hospital, Frimley Health NHS FT
• St Austell Community Hospital, Cornwall Partnership NHS FT
• Derriford Hospital, University Hospitals Plymouth NHS Trust
• Torbay District General Hospital, Torbay and South Devon NHS FT
• MYHT, Mid Yorkshire Hospitals NHS Trust
• Royal Berkshire Hospital, Royal Berkshire NHS FT
• Royal Victoria Infirmary, The Newcastle Upon Tyne Hospitals NHS FT
• Hull Royal Infirmary, Hull University Teaching Hospitals NHS Trust
• Northern site, Royal Devon and Exeter NHS FT
• Frimley Park, Frimley Health NHS FT
• Northern General Hospital, Sheffield Teaching Hospitals NHS FT
• William Harvey Hospital, East Kent Hospitals University NHS FT
