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HEALTHIER COMMUNITIES AND OLDER PEOPLE SCRUTINY BOARD REVIEW OF UNSCHEDULED CARE IN SOLIHULL Visit to Accident and Emergency Services at Solihull Hospital Members Present: Councillor Chamberlain Councillor Dr Lea Officers Present: Dr Barooah – Chief Consultant Joseph Bright – Minute Taker Jane Elwell – Lead Nurse for Emergency Nurse Practitioners (ENP) Sylvia Hughes - Primary Care Advanced Nurse Practitioner Jane Reid – Head of Adult Services Members were shown the patient pathway for Accident and Emergency Services, from initial diagnosis to treatment to discharge. The hospital staff explained the range of conditions treated in A & E from suspected broken bones to suspected heart attacks. Following the tour of A & E Services, members conducted a question and answer session with the hospital staff. They questioned how soon the staff aimed to respond to patients once they had entered accident and emergency services. The Lead Nurse for ENP confirmed that the staff aimed to assess patients within 20 minutes of visiting A & E Services. She also explained the procedures in place for nurses to distinguish minor injuries from serious cases to ensure patients with serious conditions received medical help as soon as possible. It was also highlighted that the national target for patients entering A & E services to receive treatment and discharge was four hours, something Solihull Hospital adhered to. The hospital staff made reference to cases where patients entered A & E Services and turned violent, especially on Friday and Saturday nights. The Leader of ENP services noted the procedure in place for this, whereby the nursing staff contacted the police. It was also emphasised that the hospital was currently looking at expanding security services within the hospital, as it only employed one security guard at that time. The hospital staff were asked whether there were any issues that could affect the provision of A & E services at Solihull. The Lead Nurse for ENP services explained that there was a significant volume of experienced nurses who would be reaching retirement age and this could potentially create a vacuum in staff. She explained that this issue was a national problem, where there was a lack of experienced, qualified nurses to replace retiring staff in A & E services. It was also highlighted that the nurses currently in A & E covered many shortages on the basis of goodwill. Staff also noted that there was currently insufficient capacity for intermediate care. It was explained that while there were provisions in place to support patients with minor injuries, as well as procedures to support patients who entered A & E with serious conditions, there was a need for greater rehabilitation services to support patients requiring intermediate care. The hospital staff explained that this would require more intermediate care beds plus greater support for residents at home.
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