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Piloting a solution to the bed-blocking crisis
Oxford University researcher Dr Dan Lasserson sees the units as a potential solution for what ails the NHS.
A HOSPITAL in Abingdon could have the answer to the country’s bed-blocking problems and growing elderly population.
Abingdon Community Hospital, in Marcham Road, is home to a pilot scheme – a new medical department called the emergency multidisciplinary unit (EMU).
The unit is the first of its kind in the country, but £18m of funding announced earlier this month means they are to be extended to other parts of Oxfordshire.
EMUs act as a halfway house between GPs and hospital Accident and Emergency departments.
They can treat any serious medical emergencies, except for heart attacks and strokes.
The department has an assessment ward with 12 beds and two in-patient wards of five beds, as well as a treatment room, physiotherapy room, an isolation room, and kitchen for patients to test their at-home mobility.
Blood tests, electrocardiograms (ECGs) – electrical heart rhythm monitors – and X-rays are among the tests carried out at the hospital.
Unit manager Maggie Webb said: “The model has been so successful in giving elderly patients the care they need closer to home that it makes sense for other larger towns to have them too.”
The Abingdon unit was set up on November 2, 2010 and has so far had 5,568 patient visits.
The units are to be set up in Witney, Banbury and Oxford within the next year.
Supporters say they mark a decentralisation of hospital services to take pressure off the John Radcliffe Hospital in Headington.
Hospital bosses made use of the existing facilities at Abingdon to accommodate the new unit, rather than having to provide a new building or an extension.
The day hospital that was based at the unit now provides services such as mobility classes in other parts of the hospital site.
Although the unit does not turn any patient away, its main focus is treating elderly patients closer to their own homes.
The average age of patients is in their 80s. Ms Webb said: “It is essentially a one-stop shop assessment centre for older people.
“It has been brilliant – patients are given a full assessment by doctors and therapists with the support of a social worker.
“It is mainly older, more vulnerable patients we see – it is less threatening than at the John Radcliffe and people can often attend with their families.
“Patients might have a problem with mobility or become acutely unwell with an infection which would have previously been a trip to the John Radcliffe.
“But we can now offer diagnostics, blood-testing and check that patients can cope with the day tests of daily living before they go home – if they can’t we can offer help for them at home or organise meals on wheels.”
The idea is for patients to come into the unit to be diagnosed and treated before being sent home.
Staff at the hospital include one doctor, seven nurses, one physiotherapist, two occupational therapists and one social worker.
Although most patients are referred to the hospital by GPs or are taken to the unit by South Central Ambulance Service, the unit has its own ambulance driver too – Mark Parry.
Ms Webb added: “The unit is about keeping people at home where they are comfortable and independent.
“The quicker you get them home the better because if you don’t get them back into their own home they become less confident and reliant on other people, which could mean they end up in nursing homes.”
Oxford University senior researcher Dr Dan Lasserson said: “I have presented a lot of the details about the project at conferences and there is a lot of interest in it.
“It could potentially be a model used across the country, particularly if it proved in the next few years to be financially viable. “We see the EMU as a good solution.”
EMU saves Mary-Anne London trip for treatment
AT 55, Mary-Anne Howlin is not the typical elderly patient EMUs are designed for.
But the former teacher, left, from Nettlebed, now visits the Abingdon unit every three weeks.
After a stem cell transplant in 2002 Ms Howlin developed a weakened immune system.
Before she went to Abingdon Commmunity Hospital for regular immunotherapy she had to travel to London for treatment.
She said: “I used to go to Charing Cross, which is a very long way away. The Abingdon EMU is the only place nearby which actually has a doctor in the unit – GPs can’t do it because immunotherapy takes two or three hours and I need a cannula put in.
“It works very well for me because it is one of the few places I can be treated.
“I find the unit very good. It is quite easy to get to and the staff are very friendly and patient.
“From seeing the other more elderly patients there it seems to work very well.
“It is the flexibility really of having the doctors there. I was quite surprised that you can have that at a community hospital. I’d say it is a good idea to have more.”
Aim of the game to lighten load at JR
PART of the aim behind the project was to try to relieve Oxford’s John Radcliffe Hospital, pictured, of the number of patients it sees.
In December last year Oxfordshire University Hospitals NHS Trust was forced to urge patients to stay away from the John Radcliffe and Churchill hospitals and Banbury’s Horton hospital – which have 1,200 beds – because they could not meet demand.
Head of community hospitals Karen Campbell said: “Abingdon was chosen because we looked at the number of referrals which came in from GPs to the John Radcliffe from all around Oxfordshire and we found the most came from the Abingdon area.
“So the data suggested that setting up the unit first in Abingdon would be the most effective in relieving the John Radcliffe Hospital.
“We started working with GPs from five surgeries in Abingdon itself who refer their suitable patients to us rather than the JR, but now we work with surgeries from all across south Oxfordshire.
“What we are trying to do is prevent hospital admission so patients can have a clear management plan within four hours.
“The research here at Abingdon has shown there is an impact with regard to the number of emergency department attendances and admissions to the hospitals.”
THE Abingdon Community Hospital Emergency Multidisciplinary Unit opened on November 2, 2010 It started by working with five GPs from around Abingdon who referred patients to it – and now works with 15 from around Abingdon, Wantage, Didcot and Wallingford.
The unit was initially open between 8am and 8pm, Monday to Friday, but last year extended to seven days a weekIn the time it has been open the unit has already had 5,568 patient visits.
The next emergency multi-disciplinary unit is due to open in Witney Community Hospital in October, ahead of the winter flu season.
Banbury is the next scheduled to open, at the Horton Hospital, and a unit at the John Radcliffe Hospital is planned to open after the launch of the Banbury unit.
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