Emergency care reform in Northern Ireland  improves patient access to health services and reduces waiting times

The emergency care reform programme in Northern Ireland aims to improve patient access to health services. It focuses on the complete patient pathway, from the ambulance journey to the Emergency Care Department, through the hospital system, and ending with patient discharge.

Managing effective patient flow is an important element of the reform programme. The Northern Health and Social Care Trust identified two priorities to support better patient access to health services:

• After the reform, 95% of patients who need to attend a Trust A&E Department would either be treated or admitted within 4 hours of registration
• Where a longer wait is necessary for some genuine reason, the wait is never more than 12 hours

Trust managers decided to explore how Skills for Health’s workforce tools could help improve the emergency non-elective pathway. The Sector Skills Council’s suite of workforce competences for patient flow management provided an excellent starting point. Healthcare managers decided to use the competence framework to support the reconfiguration of the bed management team at Antrim Area Hospital into a patient flow team, to help the Trust meet the challenging redefined A&E and delayed discharge targets.

Working with Skills for Health, the bed management team was able to identify workforce competences which would form the basis of two new job roles – Patient Flow Manager and Patient Flow Coordinator.

The Skills for Health team helped the bed management team to reflect on current roles and identify the most appropriate competences needed for the new roles.

“The competences provided a useful framework for developing the new job descriptions and helped us talk about a quality service rather than targets. Having competency-based job descriptions will enable us to monitor performance against national standards and plan relevant staff development activities.”

Linda Patton, Trust Patient Access Manager, Northern Health and Social Care Trust

The benefits

• Reduced patient waiting times through improved managed patient pathways.
• Successful implementation of the emergency care reform programme is leading to improved patient experience
• Improved monitoring of patient pathways from arrival to discharge from the hospital system
• New competence-based roles recognise practitioners’ skills
• Roles linked to KSF to support training and development

Managers identified that data collection was an important aspect of both roles to feed into the existing IT data system. The health informatics competences included in the patient flow suite of competences were confirmed as ideal for the new roles. Other roles that contribute to patient access and patient flow at Antrim Area Hospital have been mapped against the workforce competences to ensure a relevant skills mix is achieved.

The Service Delivery Unit, from the Department of Health in Northern Ireland, is very interested in the Trust’s competences work with Skills for Health and it’s felt there are lessons that can be learned which can be applied across other areas of health delivery. Skills for Health welcomes this successful application of workforce planning resources, which underpins real benefits to patients of competence-based approaches to the design and re-design of roles and services.

As the Sector Skills Council for the UK health sector, we support NHS, independent healthcare providers, and voluntary organisations to develop better skills, better jobs, and better health. Our purpose is to help develop solutions that can deliver a skilled and flexible workforce to improve health and healthcare.

A key aim of our experts in service and workforce design, here at Skills for Health, is to develop and manage a bank of national workforce competences which describe the performance criteria, knowledge and understanding required to carry out a work activity effectively. Because competences describe what individuals need to know and to do, regardless of who is performing the activity, they can be used in many ways.