Prestigious award for A&E and acute service innovation at the Royal Sussex

An innovation which has halved patient waiting times to see a senior specialist decision maker at the Royal Sussex County Hospital has been given one of UK healthcare’s most prestigious improvement awards.

The HSJ Value Awards recognise and reward outstanding efficiency and improvement in the NHS. This year, their ‘Acute Services Redesign’ award has been presented to Brighton & Sussex University Hospitals for the ‘Single Clerking’ initiative at the Royal Sussex County Hospital.

On arrival at A&E, every patient undergoes a process known as ‘clerking’ – the accurate recording of their symptoms, medical history and current drug treatment. Traditionally across the NHS, this has been completed twice before a patient could see a senior specialist – once by a junior A&E doctor and then again by a junior specialist doctor.

In February 2016, the Acute Floor team at the Royal Sussex County Hospital took a radically different approach, redesigning the process to remove the need for the traditional double clerking method. This ensures that the patient had a full clerking and all they required to receive the best care first time. At the same time, the team standardised forms, information and processes to make the new, single clerking, method even more safe and efficient.

Since that moment, the results have been dramatic. The time needed for entire clerking process has reduced by two-thirds; patient waiting times for senior specialists have fallen to less than half; and the opportunities for medication errors have been reduced by keeping prescribing in one place. Fewer repeat clerkings also means staff are more able to spend time looking after our patients who are already admitted, as well as focusing on educational opportunities.

On Thursday 7 June, the HSJ named BSUH’s single clerking initiative as their ‘Acute Services Redesign’ award winner for 2018.

Judges for the HSJ Value Awards praised single clerking’s simplicity and the way in which it improves the quality of care given to patients, also commenting on how the system also encourages collaboration and standardisation between a wide range of departments.

“This is an outstanding accolade for the whole Acute Floor team,” comments Dr Rob Haigh, Medical Director for Brighton & Sussex University Hospitals.

“Although changing to a single clerking system sounds simple on the surface, it has involved a huge amount of hard work and dedication to get right from all specialty and A&E teams across the hospital. Our senior doctors are now able to spend more time overseeing departments and patients than paperwork, improving the standards of care that we’re able to offer all of our A&E patients.”

The single clerking initiative has proven so successful that word has spread throughout the NHS, and 40 different Trusts around the country are now looking to follow the Royal Sussex example.