STAFF will have less than an hour to deal with patients at busy times in Scotland's newest hospital - or they will have to queue on trolleys, according to a respected A&E consultant.
Dr Tim Parke, who is among the first clinicians to start working in the new South Glasgow University Hospital, has posted a blog saying "major cases" will have to be diagnosed and treated within 57 minutes to avoid a backlog.
He notes that changes are already under way to make this happen, "but are often patchy and inconsistent".
He calls the new hospital, one of the largest in Europe, a cathedral to 21st century healthcare - but he also warns: "Valid concerns about new working patterns, transport, overcrowding and staff ratios need to be carefully listened to. Recurring problems in these areas will then need to be rapidly addressed by a leadership team who are prepared to make the changes necessary if initially processes do not work and targets are missed. Ultimately, if 57 minutes cannot be made to work we need a Plan B to avoid returning to the misery of overcrowded emergency departments experienced by patients and staff over the last two years."
Dr Parke was the clinical director for A&E in South Glasgow10 years ago before moving to New Zealand where he became clinical director of Auckland City Hospital emergency department and successfully campaigned for waiting times targets for A&E.
He has since returned to NHS GGC and was among the A&E staff who moved from the Southern General into the new SGUH on May 2. Services in the Victoria and Western infirmaries are due to follow later this month.
In his blog Dr Parke said the 57 minute figure at peak periods was based on current projected numbers, continuing: "Fifty-seven minutes to make an accurate diagnosis and clinically intervene to maximise the chances of a successful outcome. Fifty-seven minutes to establish a bond with a distressed patient and provide sympathy, understanding and compassion."
He recalled that when the case was made for centralising five A&Es into two hospital 15 years ago, Glasgow patients were told they would gain "faster more effective, efficient care with sustainable staffing in modern surroundings." Now, he said, the time has come to deliver on this promise.
Dr Parke continued: "If we are to make our 57 minutes work, the entire hospital will need to operate like a Formula 1 pit team all the time. Those patients with evidently serious problems such as stroke, major fracture, heart attack, appendicitis, or septicaemia will need to be rapidly sent to appropriate specialist care wards after receiving essential emergency treatment. There will be no time for the traditional multiple repeat assessments in A&E by a hierarchy of junior doctors from the in-patient teams. Patients with more minor problems such as cuts, sprains, skin infections will need to be dealt with in a separate fast-track stream by nurse practitioners or by re-direction to GP services."
The changes required will need a culture shift and funding according to Dr Parke. "Managers will need to realise that change of this magnitude cannot be used as a short-term opportunity to look for savings," he said. "It will be impossible to achieve the lengths of stay required throughout the hospital without realistic nursing ratios, adequate medical staffing and appropriately matched support services such as physiotherapy, radiography, labs, portering and domestic services."
If it all comes together he concluded that: "Patients should be able to clearly agree that those difficult decisions taken 15 years ago were correct."
A spokesman for NHS GGC said: "All the planning that has gone into the new hospital is designed to ensure patients move as quickly as possible to where they need to be.
"All the staff who will be working in the hospital are fully supportive of this. Every department has its part to play in ensuring we deliver the best possible care to our patients."
Meanwhile, health secretary Shona Robison said the new hospitals are already transforming patient care as she visited the site yesterday.
She said: "The £842 million South Glasgow University Hospital and the Royal Hospital for Sick Children are some of the most modern and best designed healthcare facilities in the world.
"From the outpatient self-check-in system, which will speed up the flow of patients through the hospital, to the wonderful hi-tech activity installation in the waiting room of the children's hospital - all of this new technology will help to free up staff time and improve the patient's experience of hospital care."
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