Emergency Clinic Takes the Strain

Patients who are referred to the Norfolk and Norwich University Hospital for an urgent specialist diagnosis by their family doctor may now be seen as out-patients in the Emergency Assessment Unit (EAU).

The number of patients referred to the EAU at NNUH rose by 10 per cent last year to an all time high. Now they can be diagnosed or treated at a one-stop clinic and many are able return home within an hour if their test results are satisfactory. A small number may be asked to come up the following day for assessment or further treatment.

“The clinic was set up on a trial basis in April 2004 to take some of the pressure off beds in the EAU,” explained consultant Dr Robert Mallinson. “We are now seeing six to eight patients in the clinic each morning, which relieves some of the congestion at the front door. The service will no doubt expand in the future.”

Patients are referred from their family doctor or from A&E with a wide range of conditions, from cellulitis to chest pains. If their condition is found to be serious, they are admitted to the appropriate speciality for in-patient treatment – but this currently occurs in less than five per cent of the referrals.

Cellulitis results from a break in the skin allowing bacteria to cause an ongoing infection and treatment may involve inserting a cannula in the hand for intravenous injections of antibiotics. In the last year, 350 patients with this condition have chosen to return home in between their daily injections and the service has been incorporated into the emergency clinic.

The programme has drawn interest from many other hospitals throughout the country. Community nurses are also being trained to extend this service to patients nearer their own homes.

“There are many reasons for the increase in patient numbers. Higher patient expectations and health awareness are perhaps one reason,” says Dr Mallinson. “We also live in an increasingly litigious society and doctors want to be sure their diagnosis is correct.

“In the past, patients who are not acutely ill would be waiting for their condition to be further investigated. Now they can be seen by appointment, have tests and await the results in a comfortable waiting room.”

The clinic is currently staffed four mornings a week, from Tuesday to Friday, but the service may be extended in October when a third acute and general consultant physician is recruited at NNUH.

Media contacts: Andrew Stronach or Hayley Gerrard on 01603 287200