Clinical standard 8: Ongoing review

Improving access to senior clinical decision makers and diagnostics seven days a week improvements

Royal United Hospitals Bath NHS Foundation implemented weekend consultant ward rounds, a seven day Emergency Surgical Ambulatory Care (ESAC) and an Assessment and Comprehensive Evaluation (ACE) of older people. These changes increased the availability of seven day access to senior clinicians and to diagnostics, reduced variation in the relative risk of mortality across the week, reduced the mortality risk at a greater rate than the national rate of improvement and reduced length of stay for frail older patients from 14.9 days in 2012/13 to 5.3 days in the first 6 months of ACE being implemented.

Seven day elective cardiac surgery

Papworth Hospital NHS Foundation Trust (this is also under clinical standards 5 and 6).

One stop emergency surgery ambulatory care service commissioned for 7 days a week

Royal United Hospitals Bath NHS Foundation Trust implemented New standards and pathways of care, including more weekend consultant ward rounds, seven day commissioned Emergency Surgical Ambulatory Care (ESAC) and a seven day Assessment and Comprehensive Evaluation (ACE) of older people. Variation in relative risk of mortality for non-elective has reduced, there is a sustained reduction in the risk of mortality that is improving at a rate greater than the national rate of improvement. Length of stay for frail older patients reduced from 14.9 days to 5.3 and approximately 90 bed days per month have been saved by the implementation of ESAC.

(This is also under clinical standards 2 and 5).