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Posted on 29 Nov 2016

A project which has reduced hospital admissions and mental distress to patients, and made significant cost savings, has been highly commended in the Primary Care Innovation category of the HSJ Awards. 

The Physical Healthcare Team at Rampton Hospital, which is managed by Nottinghamshire Healthcare, has been recognised for developing the service at the High Secure Hospital to enable minor surgery to be carried out in the physical healthcare centre on site. 

The team identified a need for the service development in particular for a number of patients who self harm by inserting foreign objects into themselves. Previously patients would need to be taken from the high secure environment to a local A&E department. This was often distressing for the individual who would need to be escorted under a form of restraint and have to wait for an unknown period of time to be seen. Being out of their therapeutic environment and attracting attention can also exacerbate a person’s mental illness causing further distress. 

Escorting patients out of the high secure hospital, even for a short period of time has a financial impact. It can cost over £1,000 to take someone off site and these costs increase considerably the longer the patient is out of the hospital and even further if they require a large number of nursing staff to support them. Over the last year the patients who had self harmed needed to be taken off site over 65 times which required more than 300 staff to support and totalled over 700 hours of time waiting for treatment and surgery.

By training a number of staff in the physical healthcare team in minor surgery procedures and purchasing relevant clinical equipment, these patients can now be tended to on site.  As a result, the distress to the patient is reduced as they avoid the circumstances around being taken away from the Hospital and attending an A&E department; they can be involved with the scheduling of the procedure and have it carried out in clinic rooms which are designed to be relaxing with the ability to adjust lighting and play music.   

In addition to the financial benefits there is a major reduction in security concerns as patients are not leaving the secure compound of the site. It also reduces a considerable amount of paperwork or the procedure to obtain Ministry of Justice approval that can be necessary when a patient leaves the Hospital. Patients also do not need to have the same number of staff support, nor do they require restraint when attending the physical healthcare centre to receive treatment.

Since May 2016 the team has successfully removed over 34 items from patients who have self harmed. 

Natalie Jennings, Senior Manager / Modern Matron said:  “The financial savings for the Hospital for each prevented visit to acute care is at least £1,500 to £5,000 and can be a lot more. From the prevented visits in the last six months we are confident that we have saved the Hospital as an absolute minimum over £51,000 but realistically somewhere between that figure and around £150,000.           

“The greatest outcome is the positive patient experience with improved access, less disruption to their therapeutic environment, equivalent cosmetic outcomes, staff familiarity and a very low infection rate.  We are delighted to have been shortlisted for the award and I am really proud of the team.”