SOME emergency patients arriving at the Royal Gwent Hospital this winter will start diagnosis and treatment in a new handover unit if A&E is full, to avoid having to wait in the back of an ambulance.

Delays in ambulance handovers have increased this year, with some patients having to be monitored in ambulances for several hours before they can be transferred into the hospital.

In September alone there were 933 handovers that took longer than an hour at Gwent hospitals, more than double the figure for the same month in 2018 (461).

The unit is set to be housed in a temporary building at the Royal Gwent, and is among several key components of Aneurin Bevan University Health Board's plan to cope with increased demand during the coming winter.

The number of 'majors' cases - patients who are very sick - coming into hospitals has also risen this year, in turn increasing the amount of patients who need to be admitted, and the latter are often waiting more than four hours for a bed.

The issue is not confined to Gwent, or even Wales, and other health boards and NHS trusts will be keen to find out what impact the unit has in reducing ambulance handover delays.

The project is described in the health board's winter plan report as "a key patient experience and safety scheme". It is also intended to help get emergency ambulance crews back on the road as quickly as possible.

But while this particular aspect of winter planning is targeted at hospital care provision, the principle aims once again are to prevent as many people as possible from having to go to hospital in the first place, and to get them back home as quickly as possible if they have to go in.

The plan is backed with more than £5 million of Welsh Government funding, with £3.2m of it coming through regional partnership boards, which were set up in 2016 to drive the delivery of social services in close collaboration with the NHS in Wales.

There is a big emphasis on providing support in the community, with more than 1,000 extra hours of domiciliary care being lined up Gwent-wide, and help to get the frail elderly who need to go to hospital back home as quickly as possible.

A multi-disciplinary approach will be taken with urgent primary care and out-of-hours home visits, to support patients with the right service and help them avoid having to go to hospital.

Provision will have to be made at hospitals however, to cope with extra demand. A focus on discharging patients ahead of the busy Christmas and New Year periods will aim to release 76 beds - 60 at the Royal Gwent and 16 at Nevill Hall - while extra beds are set to open in these hospitals over the festive season and beyond.

Thirty beds are being readied for opening at St Woolos Hospital (14), Ysbyty Aneurin Bevan in Ebbw Vale (14) and County Hospital (two), from January 1. though more will be required if demand is higher than forecast.

There is also an intention to provide 40 'step down' beds across Gwent from care providers, so patients can be moved out of hospital when appropriate, ahead of going home.