Hospital waiting times cut as nurses assess patients in A&E queue

Waiting times have been cut at a hospital emergency department after the launch of a scheme which sees patients assessed while they are in the queue.

St Thomas’ Hospital in Westminster Bridge Road, has moved one of the senior triage nurses from behind the desk at reception to the front door of the emergency department. 

The ‘triage flow navigator’ progresses down the queue to give primary assessments to patients. 

The key aim, according to a hospital spokesman, was to ensure “a meaningful assessment within 15 minutes of arrival”, in line with NHS England guidelines.

The role was trialled for two weeks in November 2023, and extended until the end of the year. After reviewing the improved outcomes, the senior leadership team agreed to fund the role from 8am to 8.30pm, seven days a week.

Emergency department matron John O’Neill, who helped set up the system, was inspired by a similar model in place at Medway Hospital where he worked for three years before moving to Guy’s and St Thomas’ in 2023.

He said: “The 15-minute target is there for a reason – it’s about safety. It’s all about making sure that the patient gets seen as quickly as possible and is directed to the right place.

“Sometimes demand for our emergency department can be very high, and the queue can be half way down the road. Before this role was introduced, the condition of these patients was unknown until they reached the front of the line. 

“This role takes the anxiety away, and we are already seeing the benefits.”

The triage flow navigator speaks to the patient about their condition and uses their clinical judgement to fill in a simple form, which includes a score out of five. 

Patients with a score of one or two are immediately escalated to resus. Other patients may be pulled out of the queue to be redirected to the urgent care centre or eye emergency clinic, and under 18s are taken to the children’s emergency department.

The new role also redirects people who are in the wrong place after the trial showed that about 10 to 12 per cent of people waiting in the line were looking for another department. 

Mr O’Neill said: “There are lots of benefits to the patient, including being able to have a senior decision on their pathway right from the start. We have also found that we are maximising our GP appointment allocation and reducing aggression at triage as patients appreciate being assessed more quickly.

“This ultimately helps reduce pressure on our department, with those needing to be there being seen faster, and those that are better supported elsewhere getting this information in the fastest manner possible.”

Pictured top: St Thomas’ emergency department matron John O’Neill (Picture: St Thomas’ Hospital)