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From YouTube: CQC Connect: Emergency departments responding to COVID 19 - Reduced demand, improved capacity
Description
As part of a our mini-series looking at emergency care through the lens of coronavirus, in this episode of CQC Connect, the podcast from the Care Quality Commission, we talk about reduced demand and improved capacity. We also talk about what the challenges have been; share learning and innovation; and hear from clinicians who have been on the front line.
Recorded October 2020.
Listen to more podcasts from the CQC: https://soundcloud.com/carequalitycommission
Find out more information about the CQC and how it regulates health and social care in England: https://www.cqc.org.uk/
A
Hello
and
welcome
to
cqt
connect.
My
name
is
bernadette
haney
and
I'm
head
of
hospital
inspection
here
at
the
care
quality
commission.
It
goes
without
saying
that
the
coronavirus
has
had
a
huge
impact
on
the
whole
of
health
and
social
care.
Here
at
cqc.
Over
the
last
few
months,
we've
been
engaging
regularly
with
a
group
of
senior
clinical
emergency
department
staff
from
hospitals
across
the
country
to
understand
the
pressures
they
faced
and
we
formed
a
forum
called
the
national
emergency
medicine
special
advisors
forum.
A
We'll
talk
about
the
chant,
what
the
challenges
have
been
share,
learning
and
innovation
and
hear
from
the
clinicians
who
have
been
on
the
front
line
today,
we're
going
to
be
talking
about
reduced
demand
and
improved
capacity,
and
I'm
joined
by
two
of
the
members
of
the
national
emergency
medicine
special
advisors
forum.
Can
I
ask
you
to
introduce
yourselves
please,
let's
start
with
baz.
B
C
A
B
B
B
So
for
those
of
you
most
of
you
will
know,
but
for
those
of
you
who
don't
coronavirus
in
its
early
stages,
presents
as
a
common
cold
with
fever
and
by
and
large,
these
patients
are
very
common
when
they
present
to
the
emergency
department.
So
the
challenges
we
we
faced
were
firstly
to
isolate
them
as
they
walked
in.
Secondly,
to
stop
the
spread
of
isolation
to
stop
the
spread
of
infection,
and
finally,
there
were
procedures.
B
A
C
C
One
of
them
is
the
capacity
to
manage
the
patients
coming
through
our
energy
department,
and
the
second
bit
is
the
resilience
and
the
well-being
of
the
staff
who
are
dealing
with
it
because,
as
bass
just
mentioned
earlier,
we
had
to
adapt
to
a
constant
change
which
in
itself
was
quite
challenging
for
the
for
our
staff.
The
isolation
and
the
segregation
has
bought
itself
new
challenges,
which
brings
the
brings
in
itself
the
difficulty
of
how
staff
deal
with
this
group
of
patients.
C
Lastly,
I
think
it
also
brings
that
the
crowding
within
the
emergency
department
has
magnified
itself,
because
we've
had
social
distancing,
so
we
can
have
less
number
of
people
in
the
emergency
department,
so
we
can't
deal
with
the
same
number
of
patients
who
used
to
present
before
kovid
started.
So
I
think
those
are
the
couple
of
challenges,
one
for
patients,
two
for
the
staff.
A
Thank
you
vers.
I
think
just
on
that.
We
know
that
emergency
departments
need
to
be
able
to
focus
on
the
critically
unwell
or
injured
patients
who
need
rapid
assessment
and
intervention,
and
to
do
this
they
need
to
maintain
a
manageable
number
of
attention,
attendances
and,
as
you've
just
said,
you
need
to
have
less
people
in
the
department
to
in
the
current
environment,
to
maintain
social
distance,
distancing
another
infection
and
prevention
control
measures.
A
C
C
So
one
of
the
things
in,
for
example,
where
we
have
started
in
cambridge,
is
that
we
would
patients
who
haven't
been
seen
by
the
gp
or
they
haven't
been
sent
by
nhs
111
or
any
other
healthcare
provider
we
if
they
don't
need
to
be
in
the
emergency
department,
they
are
redirected
back
to
the
within
the
community
if
they're
safe
to
do
so.
The
second
aspect
we
have
put
in
place
is
streaming
all
the
patients
who
don't
need
to
be
seen
in
the
emergency
department.
C
For
example,
if
someone
had
a
surgery-
and
they
have
come
with
a
complication
to
the
to
the
emergency
department,
they
are
then
streamed
to
the
appropriate
places
within
the
hospital.
So
I
think
the
the
crowding
becomes
to
reduce
crowding.
We
have
to
tackle
the
problem
from
different
angles.
One
is
the
exit
block.
The
exit
out
of
the
emergency
department
needs
to
be
seamless.
C
A
B
B
I
do
have
a
vision,
and
my
vision
is
this:
that
majors
majors
emergency
departments
only
sees
blue
light
emergencies.
By
that
I
mean
ambulances
that
bring
in
ill
patients
via
the
999
route.
We
think
a
e
majors
should
only
be
dedicated
to
999
emergencies
and
that
will
reduce
our
workload.
So
we
can
manage
these
patients
appropriately
thanks.
A
C
I
I
think
one
of
the
things
I
would
like
to
highlight
is
that
different
systems
have
different
strengths
and
some
places,
for
example,
urban
areas
and
so
on.
You
may
have
a
lot
of
patients
who
are
coming
in
who
haven't
seen
a
healthcare
professional
versus
another
area
where
patients
have
seen
their
gps
or
healthcare
professionals
and
they
turn
up
in
the
front
door
of
the
emergency
department.
C
After
seeing
a
clinician
or
a
health
care
professional,
but
there
is
still
a
small
group
of
patients,
so
our
what
we
have
done
is
we
have
started
direct
booking
in
not
to
the
emergency
department
but
to
our
urgent
treatment
center
to
manage
that
small
group
of
patients
who
could
be
seen
there
rather
than
be
seen
in
the
emergency
department.
This
basically
shifts
the
patients
from
the
main
area
to
to
the
co-located
urgent
treatment
center,
and
that
goes
back
to
what
bas
has
said.
C
And
I
have
the
same
vision
as
what
bas
has
got
in
the
sense
that
our
mages
area
should
only
see
non-walking
patients
and
who
are
emergency
medicine
patients
and
who
need
the
care
for
who
needs
the
doctors
to
care
for
them.
And
they
should
be
free
from
other
patients
who
can
be
seen
from
in
other
places.
A
Thank
you
for
that
that
that's
helpful
and
I
think
it's
interested
we
started
by
talking
about
bads
was
talking
about.
This
is
a
new
virus.
We
need
to
isolate
print
patients,
prevent
the
spread,
and
in
talking
about
some
of
those
challenges
of
coronavirus,
and
indeed
the
winter
pressures
that
that
have
been
faced
over
the
years.
A
You've
also
talked
about
some
of
the
examples
of
good
and
innovative
practice
that
you've
done
in
response
to
those,
but
I
just
wondered
if
there
were
any
other
examples
of
of
good
practice
that
have
been
introduced
during
the
peak
of
the
pandemic
that
have
been
adopted
that
we
haven't.
Given
you
a
chance
to
to
talk
about
so
far
vaz.
Would
you
like
to
go
first.
C
And
this
initially
we
we
did
this
because
we
needed
to
create
space
and
help
with
the
segregation
and
reduce
the
crowding.
But
what
we
have
noticed-
and
what
we
have
learned
is
that
the
working
between
the
emergency
nurse
practitioners
and
the
gps
have
helped
us
to
run
this
area
in
a
very
effective
way.
And
that
means
we
are
seeing
around
110
to
120
patients
out
of
300
in
that
area
in
a
very,
very
efficient
manner
and
very
quick
manner.
C
And
the
second
example
I'd
like
to
give
is
streaming
patients
to
red
and
green
pathways,
24
7
through
the
whole
hospital,
which
then
tends
to
take
the
pressure
off
from
the
emergency
department
and,
as
we
explained
about
how
we,
how
the
doctors
and
the
nurses
in
the
emergency
department
can
manage
the
emergency
medicine
patients.
So
I
think
those
two
examples
of
having
24
7
pathways
for
streaming
into
the
rest
of
the
hospital
and
probably
in
our
example
of
co-locating.
The
minor
injuries
with
the
utc
has
really
really
helped
us
that.
A
B
This
left
the
emergency
medicine
department
free
to
deal
with
the
new
patients
that
came
in.
I
was
so
impressed
by
the
way
they
worked,
and
I
was
also
impressed
by
the
way
the
specialists
worked.
The
consultants
of
the
specialties,
like
general
surgery,
orthopedics,
came
down
and
saw
the
patients
themselves
and
that
really
helped
us
now.
Unfortunately,
some
of
that
practice
has
tailed
off.
B
A
Thank
you
very
much.
That's
really
interesting
because
I
think
there's
a
principle
to
what
you've
both
said
about
making
sure
that
patients
are
treated
in
the
right
place
at
the
right
time
by
the
right
people
with
the
right
expertise,
and
I
think
the
the
itu
and
the
links
with
that
also
demonstrate
that
any
issues
in
a
needy
department
have
to
be
owned
by
the
the
whole
hospital
has
to
come
together
to
to
address
those,
and
indeed
the
system
beyond
that,
so
that's
really
helpful.
A
C
B
A
You
so
much
for
joining
me
today.
It's
been
so
interesting
to
hear
your
reflections
and
I'm
really
very
grateful
for
you
taking
the
time
out
from
your
busy
jobs
to
come
and
speak
to
us
and
also
thank
you
to
those
listening
as
well
and
there'll
be
more
podcasts,
so
keep
out
an
eye
out
for
those
over
the
coming
weeks.