MOBILE HEALTHCARE FACILITIES
A flexible solution to capacity challenges
Mobile healthcare facilities ‘provide a plethora of ways to manage capacity’, argues Scott Pells, director at Vanguard Healthcare Solutions, who here examines the ways in which mobile healthcare units ‘offer flexible solutions to clinical capacity challenges’. He considers the pressures on healthcare providers as demand for services continues to rise, and shares examples of how Trusts have ‘utilised flexible infrastructure as an innovative solution to managing capacity and ensuring the provision of exceptional NHS-led patient care’.
Recent months have seen an array of depressing headlines on the current ‘state’ of the NHS, with waiting lists increasingly growing, hospitals’ non- urgent operations cancelled, and patients finding it more and more difficult to see their GP, with an unfortunate knock-on effect on already overstretched Accident & Emergency Departments.
Despite health spending having been protected in recent years – while police and some ‘welfare’ budgets have suffered significant cuts – the NHS is undoubtedly facing unprecedented pressures in a number of areas, both financially and operationally. One of the key reasons the NHS is facing these growing challenges is that demand for services is rising far beyond the service’s capabilities given its stagnant resources, making maintaining high standards of care a difficult task. The average level of demand has also increased to such a degree that Trusts are finding it hard to manage capacity, even during quieter times of the year.
Cross-disciplinary demand Demand for hospital services is increasing across a wide range of areas and disciplines, including emergency and elective care, diagnostics, and many more. While attendances at major A&E departments have increased at a steady rate, the number of emergency admissions to hospital from major A&E departments has risen much faster – by a staggering 65 per cent over the period from 2003/4 to 2015/16. Referrals to outpatient services have also seen a progressive increase, with 5.8 million total referrals to outpatient sources in the first quarter of 2016/17, compared with 3.6 million in the same quarter of 2003/4, a 62 per cent rise over the 13-year period. Meanwhile diagnostic activity has risen from 2.5 million instances in the second quarter of of 2006/7, to 5.3 million in the same quartile in 2016/17.
Analysis of NHS England data reveals
One of Vanguard’s comprehensively-equipped mobile operating theatres on the road.
that the number of patients waiting more than 18 weeks for non-urgent surgery has more than doubled in four years to November 2016. Health experts say increasing waiting times are inevitable, as NHS budget allocations fail to correspond with the rises in patient demand. While it has been clearly established that demand is on the rise, the resources readily available remain largely the same. Since 2011, funding for the NHS has been rising at an annual average of just 1.2 per cent, where it appears likely to stay until 2020/21. Thus any significant attempts at expanding the capabilities of hospitals through the provision of new infrastructure or additional staffing are necessarily limited.
Frontline clinicians face constant pressure
Chris Ham, chief executive of The King’s Fund, and International Visiting Fellow, Don Berwick, spent time in 2016 shadowing a general physician on his ward to gain an insight into frontline clinical care in acute hospitals. The pair noted observing a number of challenges
facing frontline clinical staff, including old buildings and cramped layouts that compromise patients’ privacy and dignity, challenges with communications between acute medical staff and A&E personnel, and staff working under constant pressure. The overall message delivered by the pair conveyed a startling reality – that clinical staff are being stretched beyond their means, raising concerns about the impact on patients. as well as the staff themselves.
What are the options?
Trusts across the country are now at capacity even at quieter times, let alone when demand peaks during the winter months, or when facilities close for maintenance. The reality is that healthcare providers are faced with limited options: A mounting backlog of waiting list patients means many patients are waiting far longer that the target 18- week referral to treatment period, while many scheduled procedures are having to be rescheduled due to cancellations resulting from a lack of slack in capacity.
March 2017 Health Estate Journal 33
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