Cardiff and Vale A&E phone triage scheme 'the way forward'

A phone triage scheme for A&E at Wales' largest hospital is the "way forward", the project's clinical director says.

From Wednesday, patients without life-threatening illnesses will have to call ahead to be assessed by a clinician, in a bid to stop overcrowding at Cardiff's University Hospital of Wales.

Sherard Le Maitre said the project would be permanent and would be copied across Wales.

The system will not replace 999 calls for life-threatening conditions.

• 'Half of A&E team' test positive for coronavirus

• Fewer heart attacks seen by NHS amid coronavirus

• Hospital first to trial booked A&E appointments

The scheme, known as CAV 24/7, will be free to call and available for anyone in the Cardiff and Vale University Health Board area who believes they need to attend A&E at University Hospital of Wales (UHW).

The clinician will triage the patient and allocate them a slot at the Emergency Unit or Minor Injuries Unit if required. If an appointment is not needed they will be given advice on other options.

'This is the future'

Dr Le Maitre said: "This is not a flash in the pan for the pandemic.

"This is something that's going to be the future for emergency units, not only here for Cardiff and Vale but hopefully something we could look at for a wider roll out across Wales."

He added: "This is definitely the future and the way forward.

"Every health board is going to be at different stages and abilities to roll something like this out."

The move is aimed at easing "unacceptable" overcrowding at Cardiff's University Hospital of Wales

On the busiest day at UHW's A&E department last year, 515 patients attended the unit, and 311 of those would have been suitable to be processed by the CAV 24/7 system rather than presenting straight to the unit.

Patients who call CAV 24/7 will speak to a call handler trained to take information and recognise any urgent or emergency symptoms that may involve redirecting them to 999.

Someone with a non life-threatening condition will receive a call back from a nurse, paramedic or GP within 20 minutes, with hopes the service will eventually be expanded to include physiotherapists.

If an appointment is not needed they will be given advice, but those needing an appointment at an emergency or minor injuries unit will be given a time slot based on capacity at the site using a digital appointment system.

Patients who physically attend either UHW or the minor injuries department in Barry without first booking an appointment or being brought by ambulance will be assessed by a clinician at their entrances and directed to the appropriate place.

The CAV 24/7 triage centre will be based at Cardiff Royal Infirmary, where an additional 20 triage nurses have been employed to help patients over the phone.

'It's new... but exciting'

One triage nurse, Catherine Castle, said the service could help ease the burden on A&E departments dealing with people who could have been treated by their GPs or taking up capacity with accompanying family members.

She said: "Historically, people would sit there with their children or their grandparents.

"Now they will be asked 'can you attend by yourself?'

"There won't be that volume of traffic there which also causes issues and more work for busy A&E staff."

Danielle James, operational manager for CAV 24/7, said it had been challenging to plan for the "unknown" of launching a "UK-first" system.

She said: "It's a new concept, but it's exciting.

"I think everyone's pleased to be involved in this."