Gloucestershire hospital chiefs to create 24 hour unit next to A&E in bid to cut waiting times – Gloucestershire Live

Hospital chiefs have applied for permission to build a new 24 hour casualty support unit in a bid to cut A&E waiting times at Gloucestershire Royal.

Just over a week after October figures revealed that A&E waiting times across England had sunk to the worst on record, a planning application has been submitted for the new building.

Hospital chiefs say the Clinical Decisions Unit (CDU) will support the casualty department at the hospital which according to the latest figures in October treated 80.6 per cent of patients within four hours.

That compares to a target of 95 per cent and an all England average for October of 83.6 percent.

If all goes to plan work on the new unit, which will be used for A&E patients waiting over four hours tests or observation, will be built in a courtyard garden area next to A&E and the cardiology unit.

Work will start in March 2020 and be ready for the winter pressures of 2020.

Gloucestershire Hospitals NHS Foundation Trust say they need to build the new unit because there has been a 25 per cent growth in patient numbers over the last five years with attendances at the two casualty units in the county now averaging 12,866 patients a month.

The majority, 8,649 patients, attend Gloucester Royal (GRH).

Currently if patients are judged to need observation, investigation or treatment which will last more than four hours they have to be admitted. which takes up beds, or remain in casualty which is a breach of the four hour waiting times standard.

Nationally NHS bosses say many A&E departments are overcrowded because they are filled with patients who do not need to be admitted but cannot be disharged.

Under the new system they would be forwarded to the Clinical Decisions Unit (CDU) which would provide a better environment for patients and help the hospital meet its A&E targets, says the document.

"If a patient waits in ED, not only is the four hour standard breached, the environment is often unsuitable with care having to be provided in non-clinical areas," explains the application.

"When a cubicle is available, other activity and emergency pressures often mean the department is not conducive to providing quality care e.g. patients with mental health problems or the elderly awaiting results or transport home."

The planning application says the chapel courtyard at Gloucestershire Royal Hospital would be the ideal choice for the new unit because it is so close to the main A&E for the county.

The document says other available spaces on the site have already been earmarked for an extension to the casualty unit scheduled for around 2022 and Cheltenham General is landlocked.

Until now there have been ownership difficulties because part of the courtyard is owned by Apleona which has the PFI contract for the 35 million hospital extension which opened in 2005.

Originally council planners wanted the hospital to roof over the whole courtyard but NHS bosses say it has to be a separate building so the neighbouring clinical cardiology ward is not disrupted by the construction project and volunteer gardeners will create an attractive landscaping design.

Quattro Design Architects say their plans to replace the tired, unkempt, unloved Chapel courtyard with a new unit supporting A&E will improve the view for patients on the cardiology ward.

Behind every scheme we design is the principal objective to create a pleasant, attractive and sustainable development for the local area and its residents," says the application to Gloucester City Council.

A spokesman for the Trust said: "The Clinical Decision Unit (CDU) at Gloucestershire Royal Hospital will help improve the care that we offer to patients by creating an additional 24 hour short stay facility for those who require investigation, observation or treatment but do not need to be admitted into an acute hospital bed.

"It will play an important part in improving the care experience for a broad cohort of patients as it is a more appropriate environment for continued assessment and timely discharge.

"This is in line with best practice guidance to Improve Patient Flow."

The hospital dates back to 1912 when a 149-bed infirmary was created on Great Western Road but a massive 35 million expansion opened in 2005 after a PFI contract was signed.

In 2015 NHS watchdogs launched an investigatation into the Gloucestershire Trust because too many patients were waiting too long to be seen in itsA&E department and the following year it was declared in breach of its licence by the NHS regulator for failing to meet targets.

Although the situation did improve the numbers turning up at the hospital have soared and the hospital says 29,000 visits a year to A&E in Gloucestershire are for ailments that could be safely treated elsewhere.

The operational standard is that patients are seen within 15 minutes at and least 95 per cent of patients attendingA&Eshould be admitted, transferred or discharged withinfourhours.

On Friday afternoon there was a 74 minute wait with 26 people in the queue at Cheltenham General and a 95 minute wait with 61 people in the queue at Gloucester, but this can increase at weekends and winter months.

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Gloucestershire hospital chiefs to create 24 hour unit next to A&E in bid to cut waiting times - Gloucestershire Live