• Worcestershire Acute Hospital Trust invokes “full capacity protocol” due to surge in ambulance arrivals
  • Trust tells staff it must raise “acuity threshold” for emergency admissions

A struggling trust has said it must to raise the “acuity threshold” for emergency admissions and discharge due to a surge in the number of people attending its accident and emergency department, HSJ has learned.

In an email sent today to staff, Worcestershire Acute Hospitals Trust said it has invoked a “full capacity protocol” to tackle a “continuing surge in numbers of ambulances arriving at A&E”.

The email, seen by HSJ, said the trust will be “raising the acuity threshold for admission and discharge”; working with clinicians to see which patients can be discharged safely to wards; and arranging with “outside partners [to] accept patients early, or at a higher level of acuity than normal with special arrangements to follow up”.

“The [full capacity] protocol is our plan to ensure that patients are safe, and to help them to minimise the risk of harm to patients from overcrowding in the emergency department,” it added.

A trust spokesman confirmed what was said in the email, and added: “The protocol will remain in place until we achieve an increase in patient flow and a reduction in numbers of patients in the department.”

The trust will be reviewing its capacity situation every four hours and should issues persist past 6pm on Tuesday the protocol is likely to be in place on Wednesday too, HSJ understands. A senior clinical decision maker will be at the front of the A&E ensuring that patients are triaged and directed appropriately. Ward round frequency will increase to ensure prompt patient discharge where appropriate.

Another email, also sent today, from the trust’s commissioners to local GPs said the “hot clinics” made available at Worcestershire Royal Hospital for GPs to refer a number of clinical specialities to “are not being utilised”.

The email asks local providers to consider making use of these clinics.

The news comes a week before the Care Quality Commission is due to visit the trust over serious patient safety concerns raised in January.

The CQC gave the trust until the 10 March to address the concerns, which included “lack of an effective plan to address the significant capacity issues” in its emergency department.

It was also recently alleged that staff had attempted to cheat the four hour emergency admission target by using a “virtual” ward. HSJ’s investigation revealed that a trust audit did not find evidence to support a deliberate attempt by staff to cheat the target, but did find evidence of “poor processes and recording”.