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05 November 2019

UH Bristol's ENT service praised in national report

A national report by the Getting It Right First Time (GIRFT) programme has praised University Hospitals Bristol's work in its ear, nose and throat (ENT) department.

 The GIRFT report into ENT services across England recommends a range of measures to make the best use of consultant out-patient time, with the aim of improving care for patients. It highlights good practice at University Hospitals Bristol NHS Foundation Trust, where a team of three advanced nurse practitioners carry out tasks previously undertaken by hospital doctors, such as:

  • Delivering assessments before operations;
  • Carrying out weekly cancer follow-up clinics;
  • Running a tracheostomy care clinic.

The result has been continuity of care for patients and staff, extra support for junior doctors and the freeing up of consultants' time to treat other patients.

 The GIRFT report on ear, nose and throat (ENT) surgery is the ninth national report from the Getting It Right First Time programme and follows a review of 126 ENT departments across England. Written by Mr Andrew Marshall, a consultant ENT surgeon at Nottingham University Hospitals NHS Trust, it makes 23 recommendations designed to improve the experience for hundreds of thousands of patients every year by lowering the number of admissions and repeat visits and potentially reducing waiting times.

Mr Marshall says in his report: "We believe there is a significant opportunity to use consultant outpatient time more effectively by making better use of skill mix. There are opportunities for the wider multidisciplinary team, including specialist nurses and allied health professionals, to play a significant role in the delivery of ENT services."

 The review found that thousands more ENT patients could be treated on a day case basis rather than having an overnight stay in hospital. Suggested actions aimed at increasing day case rates include trusts having a dedicated day case unit or bed where possible, reviewing administrative processes to ensure patients can be listed as a day case, prioritising cases to morning or early afternoon theatre lists, and carrying out capacity planning.

 As well as enabling patients to get home more quickly, increasing day case rates for tonsillectomy operations could save the NHS between £1.4m and £3.7m per year.

 Mr Marshall added: "There is a huge opportunity for more of the national ENT caseload to be treated on a day case basis if the right facilities and working practices can be put in place. Increasing the use of day case treatment in ENT would benefit patients as well as ENT units and their trusts, making units more resilient to pressures on beds and allowing hospitals to free up beds for other people.

 "I have seen some remarkable work being done in ENT units across the country as I have carried out visits for this review. I hope the good practice case studies in the report and my recommendations help to bring about improvements which will make life better both for the NHS staff who work so hard and for the patients, who deserve the best possible care at all times."

Read the full report on the GIRFT website here.