New plans for A&E, Children's Centre and GHA holds major estate review

Director General Professor Patrick Geoghegan, outlined plans for the Primary Care Centre in the Children's Centre, a redesign of Accident and Emergency and a major review of the GHA's estate.

Prof Geoghegan discussed the plans at the latest public meeting of the GHA board, which saw members of the public quiz senior staff at the Gibraltar Health Authority.

A new Primary Care Centre in the Children's Centre will go live in early March.

Those who prefer their children receiving care at the Primary Care Centre at St Bernard's Hospital can continue to do so.

But the idea behind a PCC in the Children's Centre is so youngsters can access treatment by GPs and specialists there in a child-focused environment.

Prof Geoghegan discussed further plans, adding that the GHA is also close to launching a new dementia strategy for 2023 to 2028, which they hope to launch in mid-February.

The strategy will see a dementia coordinator appointed and Prof Geoghegan chairs the National Dementia Steering Group for dementia and will be working with the Gibraltar Alzheimer's and Dementia Society.

"We're having more and more people coming forward and being diagnosed early with Alzheimers' and we want to get in there sooner rather than later so we can do something to help that person in their life," Prof Geoghegan said.

The GHA is also undertaking a major work in reviewing its estate, including services at St Bernard's Hospital, Ocean Views, and the Children's Health Centre.

"What we're finding is that we not utilising our space as we should," Prof Geoghegan said.

"We have enough space, we have a significant amount of space in our estate portfolio, but we need to be smarter with how we use it."

"Our key objective is to free up our estate for clinical activity, that's the most important thing, and also we want to improve the environment when you come into hospital so that it’s easier to follow your way around the hospital."

Better signage, better accommodation, more comfortable accommodation, and more comfortable outpatient areas, Prof Geoghegan said, come under the review of improving local services.

He explained there is an issue with people getting lost in the hospital.

"Watch this space. By the time we have our next board meeting, I'm going to have some very, very exciting plans for you which I will be sharing with you, but I can tell you it's all good stuff."

Prof Geoghegan highlighted the recently refurbished Pre-assessment Unit as a success and will be establishing three extra rooms.

The new ENT department will be opened on February 10, Prof Geoghegan said it was the best department he has seen in his career.

The GHA is currently reviewing its services including community dental, orthopaedics, maternity, waiting times and the PCC.

The findings of the dental review have returned, with the GHA considering the recommendations.

The key finding of maternity services, Prof Geoghegan said, was that the GHA provides a safe service.

He is working on a plan of action for waiting times and, with the PCC, there have been improvements over the past few months.

He added that the GHA has worked on transparency to provide further information on waiting times only.

A&E

Prof Geoghegan plans to redesign the Accident and Emergency department, adding the set-up is no longer fit for purpose.

Over the past few months, he has implemented changes with waiting times, adding extra beds and introducing nurse practitioners.

From December 23, 2022 to January 2, 2023, over 800 patients attended Accident and Emergency, with an average 11-minute waiting time to be triaged.

During this period 1,283 called 111, some 168 were admitted into St Bernard's Hospital, 163 were discharged and 2,440 appointments were offered at the Primary Care Centre.

"That is significant within 10 days over the Christmas period and what was nice, I'd say, about that period is that no patient went without. If you needed treatment you got treatment. There were beds available for you, there were staff available for you, now you just think what was going on in the UK."

Prof Geoghegan compared how the UK saw patients on trolleys for hours and no beds.

He recognised there will always be need for improvement, but that staff have done a "wonderful job".

He added that A&E have introduced a treatment lounge where people receive care such as IVs in chairs rather than lying down on beds.

Two beds have been opened up at A&E which can see patients observed there for up to 24 hours, instead of taking up ward beds.

If the patient needs to stay longer, they are transferred to an acute ward bed.

"What we're trying to do is stop people who don't need to be in hospital from taking up a bed," Prof Geoghegan said.

The GHA has also introduced a nurse practitioner to aid the workload, and Prof Geoghegan said this is "working extremely well".

He said he is proud of the staff at A&E and reminded the public that this service is solely for those in emergency.