Changes introduced in Moray's urgent healthcare provision to prevent crowding at A&E departments amid pandemic
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THE way people in Moray access accident and emergency care is changing this month as part of a major redesign of the service.
The Scotland-wide initiative to limit the risk of Covid-19 transmission at A&E departments went live at NHS Grampian on December 1. These include A&E departments in Elgin, Aberdeen, Peterhead and Fraserburgh.
The often busy and crowded A&E department at Dr Gray's Hospital, in Elgin, is used to seeing between 400-500 people per week.
All health boards in Scotland are introducing a "flow navigation centre" to directly receive clinical referrals from NHS 24. People with non-urgent medical problems should now contact NHS 24 by phoning 111, day or night, rather than turn up at A&E.
The new centre offers rapid access to a senior clinical decision-maker, who will triage patients and direct them either to an arranged slot at emergency departments or to alternate local services such as Minor Injuries Units.
Dr Jamie Hogg, Dr Gray's clinical director, said the aim of the redesign was to schedule, as far as was practically possible, people presenting with more minor injuries to be seen at arranged slots and direct non-urgent cases away from the emergency department.
Dr Hogg explained that for people with a life-threatening problem, nothing has changed. In these situations people should still call 999 or go straight to A&E.
He said: "Covid has really driven these changes. Everyone who presents at A&E is potentially Covid-positive and the traditional model was not designed with a pandemic in mind.
"The idea is to plan as much as possible to prevent crowding at emergency departments. Change is difficult – but these are busy places and we need to keep people safe though planning as much as possible."
Dr Hogg said that although driven by necessity, he believed the changes would improve the patient experience by allowing them to be assessed more quickly and by the issuing of attendance times for A&E.
John Thomson, consultant in emergency medicine at NHS Grampian, said research suggested that around 20 per cent of patients who self-present at A&Es could be helped in a way more appropriate to their needs.
He said: "Add to this trend the restrictions placed on our capacity by Covid, and you have a recipe not just for the staff to be overwhelmed, but an avoidable poor experience for our patients."
He added: "The redesign of how urgent care is delivered in such a short space of time has been a mammoth undertaking."
The new system has been trialled by NHS Ayrshire and Arran. Its introduction is being reviewed on a weekly basis.
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