Patients at Glasgow’s Queen Elizabeth University Hospital are being transferred out of the emergency department into wards if no bed is immediately available on a ward, as part of the facility’s implementation of the Glasgow Continuous Flow (GLASFlow) model.
This model aims to alleviate pressure on the emergency department and reduce wait times for ambulance offload.
Controversy and compassion
NHS Tayside already uses a continuous flow system, but it is considered controversial by some medics as patients can spend hours on trolleys instead.
NHS Greater Glasgow and Clyde has stated that patients will be continuously monitored and not left unattended in corridors. They may be temporarily placed in an area within a ward where they will be visible to the nursing staff at all times and provided with a call bell for assistance.
Exceptions to this protocol will apply to patients in end-of-life care, those with infectious conditions requiring isolation, individuals with learning disabilities, and those in need of cardiac monitoring.
Bylines Scotland, however, has seen evidence that this isn’t always the case and that sometimes patients who should be excluded from the model are placed in ward waiting rooms until a bed becomes available.
The memo further stipulates that all scheduled patient transfers should be completed by 3pm daily and that patients moved under the GlasFLOW protocol will be accommodated in a bed or have a confirmed bed allocation in the near future.
Staff have serious concerns
However, it should be noted that this plan has been met with criticism from nursing staff who assert that they are currently grappling with overcrowded wards and personnel shortages.
One size does not fit all
Bylines Scotland has spoken to concerned staff stating that people being brought to a ward are often brought there early in the morning and still there late in the evening, on the “off chance” that a bed is made available.
Leaflet on reducing waiting times. Picture by the author, with permission
According to a member of staff:
“The ED is struggling to cope, I understand that a recent request to declare a major incident in order to get more help was declined but things haven’t really improved. We’re having to send patients to wards to ‘share the risk’ as we simply don’t have the space. We’re sending patients to wards that don’t have any rooms available, meaning patients are having to sit in the corridor and use staff or public toilets.
By ‘share the risk’, they mean clear space to let the ambulances in and foist critically ill patients off onto other wards that are also full on the off chance they may get an empty bed and it doesn’t reflect in our figures. In some instances, patients are (unknowingly) waiting for someone to die so they can get the bed. It’s 2023.Our waiting room is packed, our ambulance bays are queued out and no one seems to want to raise the profile of this incident in case it’s embarrassing to GGC. In short, we’re trying to provide first world care in what feels like a third world environment. Patients waiting in corridors for other patients to die isn’t something I thought could ever happen here, but it is happening, and the board are refusing to follow the advice of its senior doctors.”
Cleaning staff are also concerned, with one member of staff telling Bylines Scotland that the usage of corridors is poor infection control practice and could very easily lead to an increase in hospital acquired infections, including Covid-19.
Is this an unfortunate necessity?
A spokesman for NHS Greater Glasgow & Clyde said:
“Safe and effective patient flow is critical to ensuring patients receive high-quality care. As part of a range of measures being explored to help improve patient flow through our hospitals, we have adopted a model at the QEUH which aims to reduce the waiting time of patients in our A&E and assessment units to address overcrowding and the inherent risks which can come with long waiting times in A&E.”
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Ashley Black was born in Adana Turkey to a Canadian father and Scottish mother. She's a commercial pilot and has an MA Int'l Affairs from UC San Diego, Over a lifetime of "global tripping" Ashley currently advises several countries on aviation issues and has maintained a "base and home" in Scotland since 1990.
