evening handover to the Hospital at responsible for their ongoing care, rather Night team than a single consultant on call, conducting a type round of many wards. ‘safari’ Introduce Sat/Sun Consultant led medicine emergency ward rounds for high care and MAU: Example 4 Example 5 level level Introduction of Registrar-led 2 Secure additional operating time within 1 telemedicine within medicine; virtual existing job plans by implementing a three Sat/Sun ward rounds with SHO to session rota over extended working day from enable all patients to be directly 8am to -10pm, Mon-Thurs and 8am to 5pm, reviewed cf post take only. Friday. Example 6 Example 7 Example 8 level level 2/3 1 1/2 Introduction of hybrid ED staffing Introduction of model ward Friday Introduce short MAU and high model: additional registrar and focus for the weekend (Weekend care Consultant/nurse/physio Trust Grade Consultants into ED. planning): continue roll out of model board rounds on Saturdays This could potentially include ward to all wards. Friday focus on clear and Sundays: ensures telemedicine links to personal plans for all patients including multidisciplinary involvement in paramedics/nursing homes and eg. Resus status, ceilings of care rounding in acute areas without GPs to deliver 24/7 consultant cover decisions, parameters enabling discharge detracting from other weekend in ED and appropriate staffing to etc. Supported by introduction of physio requirements. ensure rapid review of patient discharge. Will also enhance directly or remotely to support multidisciplinary handover admission avoidance. arrangements/integrity. Supported by ENPs treating minor illness in addition to minor injury Interim arrangements additional – medical registrar into ED afternoons 1 on pilot basis Example 9 Example 10 level level Trauma and The on-call team for the new day 3 Further expansion of Orthopaedic Nurse 2 Orthopaedics completes a new patient clinic - 365 Specialists and Specialist Practitioners days a year. This is a consultant-led
evening handover to the Hospital at Night team Introduce Sat/Sun Consultant led medicine emergency ward rounds for high care and MAU: responsible for their ongoing care, rather than a single consultant on call, conducting a ‘safari’ type round of many wards. Example 4 level Example 5 level Introduction of Registrar-led telemedicine within medicine; virtual Sat/Sun ward rounds with SHO to enable all patients to be directly reviewed cf post take only. 2 Secure additional operating time within existing job plans by implementing a three session rota over extended working day from 8am to -10pm, Mon-Thurs and 8am to 5pm, Friday. 1 Example 6 level Example 7 Example 8 level Introduction of hybrid ED staffing model: additional registrar and Trust Grade Consultants into ED. This could potentially include telemedicine links to paramedics/nursing homes and GPs to deliver 24/7 consultant cover in ED and appropriate staffing to ensure rapid review of patient directly or remotely to support admission avoidance. Supported by ENPs treating minor illness in addition to minor injury Interim arrangements – additional medical registrar into ED afternoons on pilot basis 2/3 1 Introduction of model ward Friday focus for the weekend (Weekend planning): continue roll out of model ward to all wards. Friday focus on clear personal plans for all patients including eg. Resus status, ceilings of care decisions, parameters enabling discharge etc. Supported by introduction of discharge. Will also enhance multidisciplinary handover arrangements/integrity. 1 Introduce short MAU and high care Consultant/nurse/physio board rounds on Saturdays and Sundays: ensures multidisciplinary involvement in rounding in acute areas without detracting from other weekend physio requirements. 1/2 Example 9 level Example 10 level Trauma and Orthopaedics The on-call team for the new day completes a new patient clinic - 365 days a year. This is a consultant-led 3 Further expansion of Orthopaedic Nurse Specialists and Specialist Practitioners 2
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