Agenda item

Gastroenterology evaluation and pilot proposals

Indicative Timing – 10:45 to 11:00


At the Committee meeting in September 2018, members received a briefing paper on this pilot:


The Committee will provided with an update which will specifically address the concerns raised:


·         Access to transport

·         Potential Health inequalities




5.1      Simon Lanceley and Dr Ian Shaw updated members on the gastroenterology pilot, reminding members that the statistics provided covered December 2018 through to February 2019 and therefore included the busy winter period. The pilot ensured that patients were seen by the right speciality team and that junior doctors were available and waiting times reduced. This involved moving the service across to Cheltenham General with the exception of two acute beds which had been retained at Gloucestershire Royal..


5.2      The Committee received details of the nine metrics that were being tracked as part of the pilot. It was reflected that the data was coming from the winter period and it was pleasing to see a number of the indicators going green (positive).


5.3      Members noted the scenarios around patient experience which demonstrated the improvement in daily review provision and enhanced in-patient endoscopy service post pilot where patients were seen by the gastroenterology team on arrival. The patient feedback also showed the positive difference between the patient experience pre-move to post move. In response to a question it was clarified in some instances a junior doctor would make an initial assessment before the patient saw a member of the gastroenterology team but overall senior assessment was now happening more consistently and more quickly.


5.4      The staff experience highlighted the increased monitoring of trainees and emphasised that staff felt they were better supported and there was better provision of specialist skills and training.



5.5      The Committee was provided with detail on the pilot metrics. It was noted that initially there had been a reduction in length of stay but that had begun to rise. It was believed that this reflected a more complex group of patients going through the new designated specialist ward such as those with chronic liver conditions who tended to stay in hospital longer. It was emphasised that the figures still hadn’t exceeded the historic length of stay. This was being monitored closely.


5.6      The Chair responded to the presentation by noting that this pilot and the stroke enhancement work showed the impact on the morale and the improved resilience of staff due to being adequately resourced in order to provide better outcomes for patients.


5.7      In response to questions, it was explained that both the gastroenterology pilot and the Trauma and Orthopaedic pilot which would be highlighted in the next presentation would be part of the ‘One place’ public consultation at the end of the year.


5.8      One member asked what could be done to help reduce discharge delays and was informed that discharge was looking to be streamlined and a system-wide discharge event was taking place on the 5th June. Where appropriate, a patient would not have to wait for a consultant or senior member of the team to be discharged through the introduction of a model called ‘criteria led discharge’ which enabled a nurse or therapist to discharge.


5.9      Members noted that the provision of advice and guidance to GPs was a good sign of joined up working and some members highlighted how they would welcome more detail of that joined up working between GPs and acute care. It was explained that advice and guidance in Gloucestershire was the third highest nationally across all specialisms and this had the potential to reduce out patient referrals. 



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