Focus on same-day care under NHS 75 to free up beds in Wales

Senior nurse Donna Seldon works in the hospital's emergency room at Royal Glamorgan

Less than 25% of the 70,000 patients who visit A&E each month in Wales will be accepted.

The goal is to further reduce that number due to the scarcity of beds.

It entails putting an emphasis on same-day care and diverting patients away from the emergency room at the Royal Glamorgan Hospital in Llantrisant, as it does at other hospitals throughout Wales.

For trips, falls, or musculoskeletal injuries frequently related to sports or nights out, physiotherapists are available.

Referrals to the same-day emergency care unit are made for people who have medical issues with their hearts, lungs, or nervous systems.

According to unit chief Dr. Nerys Conway, "Acute medicine is a relatively new specialty.".

"Where we differ from the emergency room is that we don't treat minor injuries, trauma, or surgical cases.

"We are seeing patients coming through the door; they are frailer, older, and have more complex medical conditions, particularly in this region, like diabetes and heart disease.

Royal Glamorgan Hospital
A sizable portion of the south Wales valleys is served by the Royal Glamorgan Hospital.

"Since patients are getting much more complex, acute medicine just makes it possible for us to handle everything. ".

Instead of being admitted, patients can undergo the necessary examinations or scans today and then be discharged.

"I could review them once more the following day, the following week, or even a few weeks from now. However, I am able to see them safely while avoiding admission. ".

According to the most recent statistics, Wales' A&Es saw 70,310 patients during the busiest month in the past two years. With more than 5,200 patients entering the Royal Glamorgan department in May, it is not unusual.

Donna Seldon, senior nurse in the emergency department at the Royal Glamorgan hospital
According to Donna Seldon, senior nurse at the emergency department of the Royal Glamorgan, "overall, we saw about 200 patients in a 24-hour period.".

In contrast, a weekly snapshot for the end of June revealed that the hospital's acute bed availability was one of the lowest ever, with 97.7 percent of those beds being occupied.

While it is easing some of the pressure on A&E, the acute unit does not solve all of the problems. On average, it may see 20 to 30 patients per day, with afternoons and evenings being its busiest times.

According to Donna Seldon, a senior nurse in the emergency department of the Royal Glamorgan, "yesterday was an extremely busy day.".

"In total, we saw 200 patients in a 24-hour period; at one point, the department had 72 patients.

Each of the 16 major trolleys was completely full, and the waiting area was extremely crowded. ".

And that's with a fully staffed office, she added.

Every year, the number of people visiting the emergency room rises, but the workforce doesn't grow at the same rate. " .

Dr Amanda Farrow in the emergency department of the Royal Glamorgan hospital
Finding an available trolley to manage patients is still a daily challenge, according to Dr. Amanda Farrow, clinical lead for the Royal Glamorgan emergency department.

Winter pressure is a constant for us in the emergency room, according to Amanda Farrow, clinical lead for the unit.

According to her, the expansion of same-day care has improved departmental flow because fewer patients are waiting for beds, which reduces the amount of time ambulances are left waiting outside.

Official data from May show a decrease from 2,867 hours to 964 hours in the "hours lost" by paramedics while holding patients for hospital staff.

Finding a free trolley to manage patients is still a daily challenge, according to Dr. Farrow. Additionally, the waiting areas can fill up quickly.

Martin Walton in the Royal Glamorgan Hospital
Martin Walters, a patient, says, "When I come here, it's just a day turnaround — you come in, and then you go home, and I prefer that.".

By assisting patients in managing their symptoms and returning home, the medical day unit also significantly contributes to preventing admission of the sickest patients.

"They know I'm anemic and am losing blood, so they're testing me to see if I need a blood transfusion," said Martin Walters, 70, of Ynyshir in Rhondda Cynon Taf.

"I prefer that when I come here, there is just a one-day turnaround; you come in, and then you go home.

"Leave the bed for someone who is worse off than me if there is no problem. ".

Numerous patients of the hepatologist Dr. Dai Samuel, typically those with liver failure, visit the unit.

Dr Dai Samuel in the medical day unit of the hospital
According to hepatologist Dr. Dai Samuel, "Once you're in the hospital, it's actually very difficult to get out.".

We can keep some people out of the hospital. It's actually very challenging to leave the hospital once you're there, he said.

He said that as clinical director of pathology, the national shortages in that field also have an impact on how quickly tests can be analyzed.

"The pathologists must report the results of your biopsy when you undergo treatment. The next step is to determine what's happening. The radiologist or the haematologist may be required to report those scans.

"Without them, the front door practically collapses over night, and that's the problem here; the entire system is under strain. ".

The traditional nurse and doctor model would be replaced by more physiotherapists, advanced nurse practitioners, and physicians associates, according to many of the clinical leaders who spoke about using staff in new ways.

By granting staff more responsibility and freeing up colleagues, this in turn "blurs some of the professional boundaries.".

The NHS is going through a very trying time, and morale is low. Despite this, Dr. Samuel said, "I love the morale here and the team effort, and I'm definitely very lucky to work within a team that is beaten up.".

"However, they remain one. And I believe that is lacking in many hospitals. And I'm afraid of that.

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