NHS Lothian has launched a new appointment-based system for patients with urgent injuries in a bid to reduce waiting times and help ease pressures in hospital and community health care settings.
Patients with strains, sprains, suspected broken bones, wounds, burns, stings and bites are now being asked to call NHS 24 on 111 to make an appointment with an expert in one of Lothian’s Minor Injuries Units (MIU).
The new plan means that patients will make an appointment to be given the “Right Care in the Right Place” rather than walk in and spend time sitting in busy hospital waiting rooms.
Gillian McAuley, Acute Nurse Director, NHS Lothian, said: “The NHS is under some of the most severe pressure it has ever endured and our staff are facing challenges across acute and community settings.
“As result, waiting times for patients have increased, especially in our Emergency Departments. We know that some of those patients waiting in A&E could be seen sooner in our MIUs. We want patients to get the Right Care in the Right Place which in turn will help to reduce the pressures at our A&E or ‘front door’, as we call it.
“Nobody thinks of their injury as minor, especially if it is painful. But our expert MIU teams treat a huge range of urgent injuries, especially some that might be surprising – they treat broken bones, burns, sprains and painful wounds.
“By separating patients with urgent injuries and those in an emergency, we can make sure that everyone can continue to access high quality, patient-centred care when they need it most.
“If you think you need to visit A&E, but it’s not a critical emergency , call NHS 24 on 111 first, day or night.”
When patients in Lothian call 111, a trained advisor will now take all of the details and refer them for a triage assessment with a clinical coordinator from NHS Lothian.
The patient will then be given a treatment slot for later that day or the following day at one of three MIUs – St John’s Hospital, Livingston, the Western General Hospital or the Royal Infirmary of Edinburgh.
Consultations are carried out via video call or during a face-to-face appointment in the MIU depending on the needs of the patient.
The scheduling system was first piloted in the MIU at St John’s Hospital, in Livingston last year before it was rolled out to the other units in the Western General Hospital and the Royal Infirmary of Edinburgh.
The MIU team at St John’s pioneered the service and over recent months have spent time refining the way it works and passing on valuable experience to colleagues to make the roll-out across Lothian as smooth as possible.
Emma Philp, Lead Advanced Nurse Practitioner, Emergency Department, St John’s Hospital, said: “This new type of working has been really beneficial for our patients and our team, as well as colleagues in other parts of the hospital.
“It means that patients know they are going to be treated at a particular time and don’t have to spend time waiting in busy hospital departments.
“For us, it means that we can streamline the way we work to ensure we can see as many patients as possible because we know in advance the types of care we need to provide.”
“We also take referrals from the Emergency Department for patients who are not in an emergency situation and would otherwise spend a long time waiting in a department that has to work in order of urgency and acuity.”
The appointment-based system which went “live” on June 27 was launched just days after NHS Lothian warned that increasing cases of COVID-19 are placing mounting pressure on hospital and community services.
Health chiefs said community prevalence of the virus is causing serious capacity issues across the whole system.
An estimated one in 20 people currently have the virus in Scotland with two thirds of the cases identified in the 20-59 age group. This is having an impact on workforce, with one fifth of nursing staff not at work as a result of COVID-19 absence.
Relatives of patients are also being urged to help where they can by providing transport home for patients who are medically fit to be discharged, rather than have their relative wait for hospital transport. This speeds-up the discharge process and in turn frees up more hospital beds sooner, allowing faster admission for patients from Emergency Departments where admission queues can form when the hospitals are full.
Relatives are also being asked if they can consider offering support to their loved ones who have been clinically assessed as “medically fit for discharge” but might still need extra help around their home.
People across Lothian are being urged to do their bit by making sure they get the “Right Care in the Right Place” by considering going to their local pharmacy or GP or by calling 111 to get an appointment with an expert in the MIU, rather than automatically going to the Emergency Department.
If people think they need to visit A&E, but it’s not life threatening, they should call NHS 24 on 111 first, day or night. If it is an emergency, always call 999 or go to the closest A&E.
Teenager Madison Maben was among the first patients to use the pan-Lothian appointment system after she and her mum Catherine called 111.
The pair phoned 111 in the morning when Madison, 15, fell and hurt her ankle at their home in Livingston.
She was assessed and asked to come in for a face-to-face appointment at MIU in St John’s Hospital.
She said: “I tripped on the stairs because our cocker spaniel had left his toy out and I went over on my ankle. My mum phoned NHS 24 and we got an appointment really quickly.
“I was examined and had an x-ray within half an hour. It turns out I’ve got a small fracture on my ankle. The MIU team were great and really helpful.”
Catherine, a mum-of-two, said she had first thought about turning up at A&E, but worried that they would have a long wait ahead.
She said: “I was initially going to turn up to A&E but then I thought I can’t wait hours in the waiting room with two children, so I phoned NHS 24 and a nurse phoned me back within 10 minutes to give me an appointment.
“I would definitely recommend phoning 111, it was my first time using this process this morning and Madison was seen to really quickly. I wouldn’t hesitate to phone them again if I needed them.”
For more information on the Minor Injuries Unit please visit our website here.
