The proposals are the outcome of a review carried out by Noble’s Hospital’s Patient Safety Forum, a body involving all frontline clinicians.
Mr Anderson explained:
'The Patient Safety Forum, which meets six times a year, sees the planned cancellation of elective care to give as many staff as possible the opportunity to attend. The Forum enables all clinical staff across the hospital to raise any issues or concerns, review best practice, and discuss patient safety with senior managers and fellow clinicians.
At the Patient Safety Forum in November 2012 staff identified five priority themes which were subsequently developed into work-streams and led by hospital staff – including nurses, doctors, allied health professionals, senior managers and professional leaders. The findings and recommendations of the five work-streams were presented at a recent meeting of the Forum this July which I attended along with the Department’s Member for Health Services, the Chief Executive, the Deputy Chief Executive, and the Director of Finance and Legislation, with an action plan developed to take these initiatives forward. These priority themes are likely to be part of any hospital’s ongoing development agenda, and will mirror challenges faced by similar NHS hospitals in the UK.
These proposals are now being carefully considered by the Department. The consensus of the teams leading the work-streams, the clinical staff who attended the July Forum, and senior management was that three elements of work to enhance and develop care for the ‘compromised patient’ should be progressed as the number one priority, and as such three specific actions are to be fast tracked.'
The three enhancements are:
- Introduction of a Clinical Outreach Service – this involves experts in critical care, who are predominantly based in the Intensive Care Unit (ICU), providing hands-on support and advice to colleagues outside of ICU. This is with the aim of earlier intervention in the care of patients who are deteriorating and becoming acutely ill before their condition gets to a stage that warrants their admission to ICU.
- The implementation of the National Early Warning Score (NEWS) tool – recently developed by the Royal College of Physicians for implementation across the NHS to provide a standardised framework to assess the severity of acutely ill patients. This tool builds on existing systems already in place at Noble’s Hospital, namely ALERT (Acute Life Threatening Recognition and Treatment) and NEWS (Noble’s Early Warning Score).
- Using both of the above developments to ensure the earliest possible intervention by the appropriate level of doctor for acutely ill patients.
The Minister added:
'It is fair to say that some of the proposals, such as the Outreach Service – which I welcome and am glad to see being introduced here in the Isle of Man – will have an impact on resources, be it through funding, or headcount; and we are looking very closely at the implications of that.
As I’ve said numerous times since I became Health Minister, the pace of change and innovation in health care is staggering, and it remains a significant challenge to meet the demands of both clinicians and the public within the resources allocated to the Department. Thanks to efficiency measures, the Department is spending £8.6m less year on year than would have otherwise been the case and at the same time has been able to invest this ‘freed up’ funding into developing new services – such as bowel screening, the on-Island Pacemaker Service, enhancements in Breast Surgery, and the new satellite Renal Unit – as well as sustaining existing ones. But the temporary reprieve this saving has granted us – in tandem with modest budget increases – is nearing an end as the pressures continue to grow. The public and politicians alike must now face up to the fact that the way we fund the Island’s health services is not sustainable for the future if we want to keep pace with the UK and other developed countries.'