Belfast Telegraph

From long waiting times and low staff morale...how Antrim A&E is finally starting to turn a corner

New £14.2m unit helping restore faith in hospital

BY VICTORIA O'HARA

It had been considered one of the worst A&E departments in Northern Ireland.

Breaches of waiting time targets for patients and reports of staff at Antrim Area Hospital being "stretched to the limit" left morale at rock bottom.

But six weeks after the Northern Trust opened a £14.2m A&E department – almost double the size of the old unit – it appears to be turning a corner.

Major restructuring plans were rolled out to help turn services – and its reputation – around.

The Belfast Telegraph was given a tour of the new unit during which health bosses and staff admitted it was still too early to say if the changes to help improve patient flow have been a success.

But a small boost for the trust came after figures showed a dramatic drop of 335 patients waiting 12 hours for treatment in April to zero patients in June. However, it is still failing to hit a target which deems 95% of patients should be treated within four hours.

Amid the new technology and brighter and bigger space, staff said morale was slowly improving.

But it's not just about having a new building. It's about radically changing working practices as well.

Hospital bosses admitted more work had to be done, but they were optimistic.

The key changes include:

* Changed rotas for nurses.

* A new 'twilight shift' for nurses introduced nine weeks ago, from 6pm until 2am.

* New assessment area for patients, separate to A&E. This is through a GP hub with doctors ringing the unit to refer patients to specific hospital doctors, side-stepping A&E.

* An additional £800,000 from the HSC Board in April for 20 new A&E nurses – bringing the total to 75.

* Rapid X-ray reporting for GPs – providing results in 24 hours.

* Increased staffing to focus on weekend discharges.

Another key element is rebuilding a working relationship with GPs in the treatment of patients.

Since opening on June 26, until July 29, 7,019 patients have been through the A&E doors.

And among those who treated them was Mary Adams, the department Sister for 28 years. She said: "Nurses have changed their rota and medical staff have changed theirs as well, looking at the arrival loads (of patients)."

But she added it was a "whole system" approach – including working closer with GPs – that was needed to tackle the well-publicised problems.

"It has slowly but surely started to change and turn around," she said.

"It is working smarter – doctors and nurses are working in teams together now which is better, and we have more direct access to GPs.

"We have an admissions unit for them to be able to refer their patients directly to instead of coming through the emergency department."

Describing the new assessment unit, Linda Linford, assistant director of unscheduled care, said it was key in helping unblock A&E.

She explained: "The GP can determine, 'my patient's got such and such wrong with them. They need to be seen by a medical doctor/surgical doctor etc'.

"This creates another pathway for them to get to the person they need to, as opposed to coming to the emergency department and being assessed by a junior doctor."

But Ms Adams said they still felt pressure, including over the Twelfth weekend.

Olive MacLeod, director of nursing and user experience, said they had to redesign staffing to meet the times of greatest demand.

She added: "We know that is the late afternoon and the evening. Nurses have had to change their personal lives to meet the demands. Many of our nurses are young mothers but they have been tremendous in their efforts."

Calum MacLeod , interim medical director, praised the staff's high skills standard, without which "we would have got into even greater difficulty".

"There will be pain involved for some people undoubtedly, that is why we are having this ongoing conversation. But we are confident our direction is the right one and people will come along with us."

 

'The staff were amazing'...Two patients' stories

 

Jamie Leitch (18 months) treated after drinking bleach

Little Jamie Leitch was among the A&E patients rushed to Antrim Area for treatment.

His frightened mum Katrina dashed to the new A&E department recently after the 18-month-old accidentally drank from a bottle of bleach.

The mother-of-three, from outside Glengormley, said she couldn't praise the staff highly enough.

"We arrived at about 9.10am. It was just pure panic. We just rushed straight up. The staff were just amazing and we were seen right away."

The 35-year-old added: "He was tested for everything, they took his bloods right away and he has been monitored for six hours.

"I think he will just be left with a little burn to the roof of his mouth – but he is OK, thankfully.

"I think I was more frightened that he was. But I was just so relieved, you can't turn your back for one minute."

She said the new unit is fantastic.

"I've three children, one is five the other is 15, and Antrim is the first A&E I would come to.

"I've had horrific experiences in other A&Es and I wouldn't go anywhere else.

"I would have more confidence here than any other. I find even the waiting area for the children cosy and it has a family feel."

 

Peter Montgomery (17) treated after hurting foot

Peter Montgomery (17), from Broughshane, also called into A&E after injuring his foot.

"I fell and hurt my foot. I didn't know if I had broken anything. I was seen very quickly. I've been in about an hour now and already had an X-ray taken and am just waiting for the results."

After checking his X-ray Peter was told he had suffered a sprain.

His mum Sharon said she was very happy with the treatment her son received.

"I understand people are busy. At the end of the day they can only do so much," she said.

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