Team with goal to save lives

IT has been another hectic day trying to cope with the ever-increasing demands of the National Health Service. Dr Richard Hixson sits back in his chair, thankful to take a breather, and makes a bold assertion: “I genuinely think we are breaking the mould with what we are doing here.”

He is in the Memorial Hall, a grand old building which has stood the test of time on a site behind Darlington’s war memorial. It is the only remaining part of the original Darlington Memorial Hospital which was opened by Prince George in 1933 – 15 years before the NHS was founded by Nye Bevan.

The health needs of the nation, and the way they are served, are very different from those far-off days. The NHS, often criticised yet still widely cherished as a national treasure, must constantly evolve to deal with the extra pressure it faces from a growing population that is living longer.

LEADERSHIP: Dr Richard Hixson and Lisa Ward

“Providing health care 24 hours a day, seven days a week, is incredibly challenging, and increasingly complex,” admits Dr Hixson.

But the County Durham and Darlington NHS Foundation Trust, which Dr Hixson serves as deputy medical director, is preparing to pioneer a new way of tackling that challenge at Darlington Memorial Hospital and the University Hospital of North Durham.

This month, the trust began training the Acute Intervention Team, made up of 13 nurse practitioners and 12 senior health care assistants.

The team is the result of in-depth discussions with a group of consultants representing a range of specialisms – respiratory, palliative care, critical care, cardiology, paediatrics, and emergency medicine among them – about the best way to provide effective round-the-clock care for patients in the modern era of the NHS. It is that core team which Dr Hixson believes is destined to break the mould.

Nearly 90 per cent of Britain’s hospitals are covered by some form of rapid response team, dealing with the sickest patients, but this is the first time nurses and health care assistants have been brought together in a team trained directly by specialist consultants. The plan is to have them ready to be launched as an active team by December and, although it is seen as an ambitious step to take, Dr Hixson is convinced it will pay dividends.

“The aim is to increase the level of specialist understanding in the hospitals in Darlington and Durham and to equip them with the skills needed to deal with emergency situations,” explains Dr Hixson.

“The nurse practitioners have been carefully recruited from areas where they had experience of dealing with the sickest patients. They are already highly skilled, but, after the training, they will possess a range of skills not normally possessed by nursing staff.

“By bringing them together with health care assistants, whose skill levels will also be raised, we are creating a stronger safety net capable of covering that round-the-clock demand. It is a new approach but one which was born out of discussions with the consultants.”

Lisa Ward, lead nurse in cardiac arrest prevention, has also been at the forefront of the work which has led up to the formation of the Acute Intervention Team.

In 2012, she helped form the Cardiac Arrest Prevention Team, which set out to come up with a local solution to a problem facing the health service across the country. It is a problem underlined by a grim statistic – that if you have a cardiac arrest while in hospital, there’s only a 17 per cent chance of surviving to the point of being discharged.

Lisa’s team set out to gather and analyse data about cardiac arrests across the trust and educate staff about how they could be prevented. Since then, there has been a 20 per cent reduction in in-patients suffering cardiac arrests in the County Durham and Darlington trust. The objective now is to build on that progress through the expert training given to the Acute Intervention Team.

“It is an exciting time because we really believe this will make a huge difference to patient care and safety,” says Lisa. “And, of course, we want it to evolve and develop in the light of the team’s experiences.”

Another key difference in the new approach is that the new team will complement existing palliative care services. “The aim is for intervention to take place in the right circumstances but it is also vital that patients who have reached the end of their lives are allowed to die with dignity,” says Dr Hixson.

“Risk exists in any health care system but it is about identifying those risks, minimising the mistakes, and learning how to prevent a recurrence.”

So the mould is being broken in County Durham and Darlington and time will tell whether it was a worthwhile experiment. But for Dr Richard Hixson, Lisa Ward and members of the new team they are leading, standing still amid the ever-changing challenges of the NHS is simply not an option.