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SNPs cut waits and improve care

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A team of surgical nurse practitioners (SNPs) has helped reduce A&E waiting times and significantly improved patient care at Leeds Teaching Hospitals NHS Trust.

Since December 2006, SNPs in the surgical assessment unit at the trust’s St James’s Hospital have used strict, protocol-based criteria to take direct patient referrals from A&E staff.

The SNPs see patients with a variety of common surgical conditions, including appendicitis and haematuria. Once they have carried out an initial assessment, the nurses organise relevant investigations such as blood tests and X-rays.

This means that time that would normally be spent waiting for a doctor is used to carry out tests, saving time overall. If the patient requires hospital admission, the SNP speeds up the process by starting treatment and providing a full care plan before the patient reaches the ward.
The system has also reduced inappropriate admissions. In the first month of the service around half – 68 out of 130 patients seen by SNPs – ended up not requiring admission.

Latest figures show a similar trend for the first three months of this year, with 260 of the 600 patients referred to SNPs not being admitted.
One of the trust’s three SNPs, Naomi Assame, said that previously acute patients would arrive on busy surgical wards from A&E with no plan
of care.

‘We can take patients out of the A&E system quickly and provide them with specialist care straight away. If they do get admitted to a surgical ward, they will already have a care plan in place based on our specialist knowledge,’ she said.

Mike Hayward, RCN adviser in nursing practice, said more government investment in specialist nurse practitioners was needed. ‘Although there are small pockets of excellence, it is a sad indictment that these types of roles have not been centrally funded and rolled out nationally,’ he said.

‘The government needs to recognise that the time and energy invested in these programmes is worthwhile because they obviously do make a difference,’ he added.

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