Released 1 August 2022
Request:
1. How many SI’s have been raised for all incidents where a handover greater than 60 minutes has occurred.
In line with the attached letter page 6. 10.Must raise an SI for all incidents where a handover greater than 60 minutes has occurred.
2. Who is the senior lead, directly accountable to the Trust Board, to oversee the development and implementation of clinical handover protocols for acute departments. Page 3, section 1.
3. Do all the nurses, doctors and managers in the ED know that the patient is the responsibility of the ED from the moment that the ambulance arrives outside the ED department, regardless of the exact location of the patient.
Page 2 and how has this been handled and verified.
4. Page 3 item 6. Must have an agreed protocol for the timely escalation of handover delays with established warning and trigger responses. This should include a clear policy to manage waiting ambulances safely with regular risk assessments and required actions in order to deliver a safe waiting environment for patients.
Please can I have a copy of this protocol.
5. Page 5 Must enact a handover escalation protocol where time to handover is exceeding 30 mins. This should include contacting the on-call Hospital Director so that immediate action can be taken to release ambulance resources. Where time to handover is exceeding 60 minutes, the on-call CCG Director and on-call NHSE Director must be contacted and those individuals should put in place whole system local escalation processes to release ambulance resources. Over winter the regional winter on-call Director should also be informed 24/7.
Please can I ask how many times an on call director has been contacted so that action can be taken.
How many times the on-call CCG Director and on-call NHSE Director has been contacted.
Assistance provided under Section 16 [duty to assist] on 07 July 2022:
Can you please clarify the time period relevant to questions 1 and 5 of your request?
Clarification received 07 July 2022:
The dates are from 01/04/2021 to 31/03/2022 a 1 year period.
Information disclosed:
1. Section 41 exemption [information provided in confidence] was applied.
2. Managing Director for Unscheduled Care (interim)
3. Yes, our teams are fully briefed and aware of the vital nature of handover from ambulance to ED. We have a clear and established set of standards pertaining to handover that all teams working in the ED are aware of and understand their responsibilities within.
Our nurse in charge and our consultant in charge alongside our triage nurse have the direct responsibility to offload ambulance patients and to avoid waiting times. Our Deputy Director of Operations and our Director of Operations work on a daily roster to support flow and have ambulance handovers at their top priority.
4. Yes, we have a clear protocol for managing ambulance handover delays and the escalation therein. This is overseen by our Deputy Director of Operations and our Director of Operations for ED and supports the speedy handover of ambulances.
This protocol is part of the wider Trust full capacity protocol and outlines steps to support off-loading of patients from ambulances within established timeframes to support crews back on the road.
5. The Trust does not maintain a central log of this activity. Since this information is not held by the Trust, it is not available under the terms of the FOIA at this time.