Healthier Communities and Older People Scrutiny Board – Visit to by dfhrf555fcg




         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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