How we’re modernising services to support patients and staff
To help improve patient experience across hospital sites within urgent and unscheduled care services, we are constantly developing and implementing new and innovative pathways which help us provide additional and faster routes for them to access urgent and unscheduled care as an alternative to A&E.
These new pathways and services improve patient flow through our hospitals, avoid unnecessary bottlenecks and ensure our capacity is being utilised in the most efficient way possible across all of the health service.
This webpage outlines some of the work underway to deliver this ambitious project, which is overseen by the Urgent and Unscheduled Care (UUC) Oversight Board.
Virtual Pathways
Technology is playing a key role in modernising our health services and the creation of virtual pathways is already having a significant impact on our urgent and unscheduled care patients. Virtual pathways enable us to provide urgent care outside of A&E, and in many instances, in the comfort of the patient’s home –freeing up valuable capacity within our acute sites and giving our patients a better experience.
At the core of virtual pathways lies the FNC which launched in December 2020. The FNC enables patients who would otherwise visit A&E, to receive a direct video or telephone consultation with an emergency care clinician. Externally the FNC is branded as virtual A&E. You can find out more information by visiting our FNC webpage or watching the video below.
Interface Care
Interface Care is new approach to enable primary and community care providers such as GPs to access immediate specialist care advice from acute colleagues to help assess patients who may otherwise be sent to A&E.
The programme is currently in development, with new respiratory pathways coming online alongside heart failure pathways. With more immediate clinical advice being made available, the hope is to ensure patients receive the right type of treatment for their needs, faster, and without having to be admitted to hospital.
Falls and Frailty
Our teams are working closely with HSCP / Scottish Ambulance Service and other partners to establish new methods of A&E avoidance for elderly and vulnerable patients who would otherwise have been sent to hospital.
By linking these specialist frailty teams as early as possible in the patient journey, often patients are able to be discharged from hospital faster, or avoid A&E altogether.
Home First Response
Home First Response launched in November 2022 and helps provide targeted interventions to older and vulnerable patients who would otherwise spend long periods of time in hospital. Being treated at home provides significant benefits – increasing recovery time, preserving mobility and reducing the chance of delirium.
As part of the rollout, specially trained HSCP staff have been recruited and embedded alongside acute frailty teams at Glasgow’s Queen Elizabeth University Hospital and Paisley’s Royal Alexandra Hospital to help limit admissions, improve early discharges and support anticipatory care planning.
Outpatient Parenteral Antimicrobial Therapy (OPAT) service
OPAT is a specialist-led service which provides acute-level hospital care in an outpatient capacity to patients with complex infections is playing a critical role in freeing crucial bed space in hospitals across NHS Greater Glasgow and Clyde.
Based at the QEUH in Glasgow, but with outreach to hospitals throughout NHSGGC, the specialist OPAT team is made up of nurses, pharmacists and infectious disease consultants and can see more than 100 new referrals each month.
The service treats patients with infections who require IV antibiotics either on a short or long-term basis but who are otherwise suitable for outpatient treatment. This might include, for example, patients suffering cellulitis, which is a common skin infection or, a range of other difficult to treat infections, for example, complicating diabetes, chronic lung disease or surgery.
About one in three patients are referred direct by GPs and avoid hospital admission altogether while two thirds (usually with more complex infection and requiring initial hospital investigations and treatment) have their hospital stay significantly shortened. For patients that require an initial inpatient stay, the time spent in hospital is shortened by an average of three weeks per patient.
Hospital at Home
Hospital at home aims to keep patients out of hospital by providing the same level of high-quality multi-disciplinary care they would receive as inpatients.
Eligible patients are identified either upon presenting at A&E thus avoiding admission, or to enable an early supported discharge, or they can be referred by their GP. Patients need to be over the age of 65 to be suitable for the service.
An example of a hospital at home patient would be an elderly person who has fallen at home, has a severe infection, delirium, or who has seen an acute functional decline due to an existing health condition. Individual assessments take place for each patient before a decision is made.
Patients who are treated within Hospital at Home also have access to hospital-level diagnostics, such as endoscopy services, radiology, cardiology and a range of urgent hospital-level interventions such as IV therapy and oxygen.
Care is delivered by a team of Nurses (including Advanced Nurse Practitioners and Consultant Nurse), GPs, Pharmacists, Occupational Therapists and Consultant Geriatricians.