Capacity to Care – Are You Up For The Challenge?

Two new challenges have been launched to encourage staff, primary care colleagues and social care partners across Forth Valley to make changes that will help release valuable appointment time and free up inpatient beds.

This includes reducing the need for face-to-face outpatient appointments, preventing avoidable hospital admissions and reducing delays which stop patients from being discharged from hospital when they have recovered.

Bed Days Challenge: Do things differently so that people spend 10,000 days at home instead of having to be in hospital. This amounts to around 3% of 346,766 occupied bed days. The average occupied bed day costs £465.

Outpatient Appointments Challenge: Make changes that will save patients 10,000 unnecessary face-to-face outpatient appointments. This amounts to roughly 670 clinic sessions and an average cost per appointment of £103.

See the home page of the staff intranet for more information and details of how to register.

Setting An Example

Arthroplasty Nurse Mary McDermott is running a trial at Forth Valley Royal Hospital which helps avoid patients with knee and hip replacements having to travel to the hospital for face-to-face clinic appointments. The new pilot service is already freeing up consultant time to see new and urgent cases.

It involves local staff checking patients’ progress by telephone and, if there are no particular problems, asking them to attend a routine X-ray within the next three weeks at a time convenient to them. This could be at Forth Valley Royal or Stirling Community Hospital.

Mary explained:  “We watch for signs of loosening and wear and tear. Once that happens we can work with patients to decide whether to revise or re-do the replacement joint. Checks always used to be carried out at face-to-face clinics but patients contacted so far by telephone like the idea. It means they don’t need to take time out to travel to hospital. They also appreciate the three week window for an X- ray appointment because it gives them a choice of when they can attend.”

Any patients who report problems or pain when contacted by phone are booked in for a face-to-face appointment as soon as possible and advised to have their X-ray before attending.

Several hundred hip and knee replacements are carried out annually in NHS Forth Valley. Checks are made at one year, then at five yearly intervals until 15 years. After that, patients normally undergo an annual assessment. Staff are currently designing feedback forms to officially evaluate the benefits of the pilot service and, if successful, the approach could be rolled out to other clinics.