Pressures on the NHS are greater than ever; ageing hospital estates are often proving no longer fit for purpose, levels of available community care are insufficient and capacity issues continue to rise.
Here Keith Austin, CEO of EMS Healthcare, considers the ways mobile and modular medical units can ensure patients are guaranteed high-quality care, alleviate facility pressures and significantly reduce patient service time. Growing pressures
The ageing UK population has led to a shift in demographics, with more people aged 65 and over being at greater risk of chronic health conditions that require ongoing treatment. This surge in demand is proving difficult for the NHS to cope with.
As the population ages, so too do the premises in which our health services operate. The majority of estates in the UK’s healthcare system were built for purpose at the time, but over time have become unfit for today’s modern healthcare provision – something not helped by the amplified footfall within hospitals today.
The knock-on effect of ageing estates and heightened demand includes increased capacity pressures – it is no secret that the NHS is experiencing ever-growing backlogs of patients on waiting lists. Whilst little can be done to reduce the demand, it is possible for estates to increase capacity and ensure patients are seen in a safe and clinical environment.
A common answer to the creation of more space is carrying out hospital refurbishments. Going down this route can offer a long-term solution to trusts experiencing capacity pressures, but it comes at the high cost of time and money – both of which are currently in short supply in the NHS. Decision makers must think outside the box to alleviate these pressures and adapt to the changing demographics, whilst keeping the patient experience as a priority.
One way that healthcare providers are innovating is through mobile and modular units that can be modified to deliver solutions to a number of issues within the healthcare sector. At EMS Healthcare, we design, create and deploy fully DDA-compliant mobile medical units that provide extra space for clinical areas such as ophthalmology, renal dialysis and infusion, in some cases creating up to 250 more patient slots per week. The quality and versatility of these units are now so high that many patients prefer attending mobile or modular-housed appointments rather than the hospital setting.
Exceptional estates
Exceptional care is being delivered across the country, sometimes in facilities no longer able to cope with demand and meet facility requirements. One of our clients, St George’s University Hospitals NHS Foundation Trust, is renowned for its kidney patient survival rate, with renal services rated ‘outstanding’ in a recent Care Quality Commission review. However, the same review called for the trust to urgently rebuild its 120-year-old Knightsbridge Wing.
St George’s faced the prospect of relocating its entire renal department either to other locations within the hospital, nearby hospitals or to satellite dialysis sites in converted buildings away from the original ward. Each option had a drawback, whether it was disruption to patients’ routines, no guarantee of using the same nursing team, overcrowded departments or the inability for St George’s to control the level of service.
A comprehensive solution came in the form of our Liberty Quad unit – a four-trailer, fully independent facility with seven renal stations for chronic dialysis, as well as a reception and waiting area, nurses' station and clean and dirty utilities.
Liberty Quad now successfully facilitates uninterrupted services for patients directly at the hospital site with the same clinical team patients are familiar with. St George’s has been able to maintain outstanding levels of renal care in difficult conditions, and focus its attention on rebuilding the renal department.
Community care
Alongside alleviating the pressures of heightened demand and ageing estates, mobile units have the capability to offer unprecedented levels of patient experience through flexible relocation which reaches the heart of communities. This meets the target for more out-of-hospital care underlined throughout the NHS’ Five Year Forward View, a set of guidelines placed in 2014 to ensure sustainability for the service.
Travelling to hospital appointments, especially for regular treatments, isn’t always convenient for those who may struggle to arrange travel; there is a very current and increasing need for flexible services, and more community-led care. This was the reasoning behind a new unit we recently developed, Quest+ – designed specifically for the treatment of macular diseases such as wet age-related macular degeneration, an eye condition that causes individuals to lose central vision. The unit takes just one hour to set up and can be moved daily, providing clinicians the support to reach patients with reduced vision that require regular intravitreal injections.
The ‘one-stop’ community-based assessment and treatment unit not only offers uncompromised care throughout treatment, but also increases hospital efficiencies by taking patients out of the main hospital environment. An excellent example of this is the project we have been working on with Frimley Park Hospital over the past three years, in which we deployed our two-trailer Liberty unit to aid the delivery of quality care for macular patients.
The unit is moved to a different convenient location each week, and has created 12,500 more patient slots per year. Since it was first installed in 2014, patient experience has vastly improved, with 92% of surveyed patients agreeing the unit is more convenient than attending appointments at the hospital. The number of patients with acceptable waiting times has risen from 12% to 96%, and 95% rated their experience of the unit as ‘excellent’. Prior to the partnership, patients were spending one hour, 21 minutes on average in the hospital’s macular department – this has now reduced to just 32 minutes on board the mobile unit.
Collaboration and implementation
Using suppliers, such as EMS Healthcare or others on the NHS’ Mobile Diagnostics, Theatres, Treatment and Therapy Services Framework, will allow for a quicker procurement process and deployment within six to eight weeks of enquiry, allowing units to be installed in a reactive manner. However, the best results we see are always when trusts plan ahead and recognise that an issue is approaching.
Mobile and modular builds not only offer significant value to estates and facilities teams but also provide obvious benefits for clinicians, nurses and property managers too. The rise in demand across NHS services impacts all areas of operation and it is vital that decision makers across the board collaborate in implementing innovative solutions for a sustainable NHS.
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