A London hospital has slashed waiting times in A&E by having patients assessed while in the queue.
The system, pioneered by St Thomas’ Hospital in Lambeth, aims to give patients a clinical assessment within 15 minutes of arrival.
The new way of working has moved one of the senior triage nurses from behind the desk at reception to the front door of the emergency department, where they move down the line and assess patients.
Patients discuss their condition with the nurse before being given a score out of 5 based on the severity of their problem. Anyone with a score of 1 or 2 is immediately escalated to resus.
Other patients may be pulled out of the queue to be diverted to an urgent care centre or an eye emergency clinic.
A trial undertaken at the hospital has found that the method can effectively reduce crowding in A&E by redirecting patients who need alternative NHS services.
Data from the trial shows that around 10 to 12 per cent of those in the queue for A&E were actually looking for another department.
Emergency department matron, John O’Neill, told the Standard: “Sometimes demand for our emergency department can be very high, and the queue can be halfway down the road.
“Before this role was introduced, the condition of these patients was unknown until they reached the front of the line. This role takes the anxiety away, and we are already seeing the benefits.”
The latest NHS data shows that 7,239 Londoners waited more than 12 hours from a decision to admit to actually being admitted to A&E in June.
But only 72 patients waited more than 12 hours at Guy’s and St Thomas’ NHS Trust, which manages St Thomas’ Hospital – one of the lowest figures of any Trust in London.
Mr O’Neill added: “There are lots of benefits to the patient, including being able to have a senior decision on their pathway right from the start. We have also found that we are maximising our GP appointment allocation and reducing aggression at triage as patients appreciate being assessed more quickly.
“This ultimately helps reduce pressure on our emergency department, with those needing to be there being seen faster, and those that are better supported elsewhere getting this information in the fastest manner possible.”
The triage system was initially trialled for two weeks in November 2023 and then extended until the end of the year.
Improved outcomes in A&E led the senior leadership team at the hospital to agree to fund the role from 8am to 8.30pm, seven days a week.
