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Nurse-led trial redirecting ED patients saves hundreds of hours

Nurse and GP at London hospital triage arrivals and send any with minor complaints elsewhere in trial that has saved around 450 clinical hours in first two months
Picture shows the main entrance of Northwick Park Hospital in Harrow

Nurse and GP at London hospital triage arrivals and send any with minor complaints elsewhere in trial that has saved around 450 clinical hours in first two months

Stationing emergency department (ED) nurses to direct patients with minor ailments to more appropriate NHS services has saved hundreds of clinical hours in a trial at a London hospital.

Since December, Northwick Park Hospital in Harrow, northwest London, has placed a senior nurse and GP in its ED to triage people and see if they need urgent care. Each person is assessed and if they have minor illnesses they are advised on self-care or redirected elsewhere, such as to GPs, pharmacies or other appropriate services outside the hospital.

    Nurse and GP at London hospital triage arrivals and send any with minor complaints elsewhere in trial that has saved around 450 clinical hours in first two months

    Picture shows the main entrance of Northwick Park Hospital in Harrow
    The main entrance of Northwick Park Hospital in Harrow Picture: Mark Hakansson

    Stationing emergency department (ED) nurses to direct patients with minor ailments to more appropriate NHS services has saved hundreds of clinical hours in a trial at a London hospital.

    Since December, Northwick Park Hospital in Harrow, northwest London, has placed a senior nurse and GP in its ED to triage people and see if they need urgent care. Each person is assessed and if they have minor illnesses they are advised on self-care or redirected elsewhere, such as to GPs, pharmacies or other appropriate services outside the hospital.

    Since its launch on 13 December more than 1,750 patients have been redirected, with the highest total for a single day reaching 82. Based on the average urgent care appointment being 15 minutes, this has already saved around 450 clinical hours, the trial found.

    Some 190 of those patients were directed to a GP appointment while a further 350 were given advice on self-care, including over-the-counter medication from a pharmacy.

    Nurse-led pilot could change the way services are delivered in future

    The nurse-led pilot is run by Harrow Health GP Federation, a not-for-profit organisation owned by local GPs. Its lead nurse Jackie Wilmot said it could change the way services are delivered in the future. ‘This project has enabled me to utilise my years of clinical skills to ensure that patients are treated in the right service at the right time,’ she said.

    Northwick Park Hospital is run by London North West University Healthcare NHS Trust. Its head of emergency nursing, Tricia Mukherjee, said: ‘The service provided by Harrow Health has been extremely helpful in getting patients to the right place in a timely manner. They have assisted patients in getting appointments with a GP as needed, which had been contributing to a large number of attendances and made the patient experience much more positive by reducing waiting times.’

    To support the ED nurses an extra 65 primary care appointments were made available for patients redirected from hospital.

    Harrow Health chief executive Adam Mackintosh told Nursing Standard the pilot would not have been possible without the support of nurses at the hospital. He said other hospitals in northwest London are considering similar schemes.


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