SOME emergency ambulance patients in Gwent could ‘bypass’ A&E and go straight into medical assessment units, as part of plans to ease the burden on frontline hospital services.

There are also proposals to redirect some patients from the Royal Gwent Hospital to Ysbyty Ystrad Fawr at Ystrad Mynach, based on their conditions or injuries. And the area’s GP pay rates are to be reviewed to try to improve the GP out-of-hours service and avoid gaps in its rosters.

These are among over 30 measures being considered and/or introduced by Aneurin Bevan Health Board as part of its unscheduled care plan, which seeks to ease the burden of demand, primarily on A&E departments and the ambulance service.

Though overall attendances at A&E in Gwent have fallen slightly this year, the numbers of ‘majors’ cases – often elderly patients with a range of chronic conditions – is increasing and placing greater strain on departments.

About half of emergency ambulance attendances do not result in admissions. Health boards across Wales and the ambulance service are seeking ways to identify patients who may not need to go to A&E.

Some – mainly elderly – patients are already being redirected by paramedics to Gwent’s Frailty Programme, offering enhanced care in people’s homes, and there are plans to introduce an element of Frailty Programme assessment at A&E to identify others. See the unscheduled care plan at aneurinbevanhb.wales.nhs.uk

The health board has invested heavily in consultant acute physicians to work at the Royal Gwent, Nevill Hall Hospital, and at Ysbyty Ystrad Fawr, to deal with patients whose conditions are deemed appropriate for assessment to determine whether an admission is necessary.

This investment has also meant that consultant physician cover can be extended beyond core hours