What is the challenge your project is going to address and how does it connect to the theme of 'How can we improve across system boundaries?​

Poorer outcomes and increased lengths of stay are both attributed to delays in transferring patients to the appropriate healthcare setting. The 3 Norfolk acute hospital Trusts have seen an increase of patient transfers of 31% from 864 in 2020 to 1253 in 2023. The lack of bed availability and ambulance surge times have significantly impacted on the ability to transfer patients in a timely manner.
Current individual Trust’s transfer policy refers to what is within the organisations gift to influence and not the expectation or responsibility of the receiving hospital. Challenges will be to foster a culture of collaboration and apply systems thinking to develop a transfer framework. This project aims to reduce the length of time it takes a patient to access the service or treatment required and therefore improving patient outcomes.

What does your project aim to achieve?

To provide a standardise framework for all staff involved in the transfer of patients between departments and other Norfolk hospitals it is proposed a Norfolk and Waveney hospital patient transfer policy would encompass overarching principles to:
• support partnership working in the best interests of the patients
• promote equity of access to specialist healthcare for patients
• outline the responsibilities for both referring and accepting organisations
• provide an agreed method for cross site escalation; functional and/or hierarchical
• ensure the safe transfer of patients between hospitals or departments using a risk- based approach
• appropriate utilisation of ambulance provision

How will the project be delivered?

The Interfacility Transfer Group (ITG) has representation from acute and private healthcare providers and East of England ambulance transport services (including the Adult Critical Care Transport Service) in the Norfolk and Waveney Integrated Care System. The ITG aims to improve the quality of hospital transfers in Norfolk and has used an improvement methodology to develop a Risk Assessment Tool (RAT) to be used for the transfer of unplanned emergency patients.

To support the introduction of the RAT consistently across the Trusts the ITG will develop a transfer policy to align practices, positively impact on a partnership culture and set out clear roles and responsibilities. By forming task and finish groups with operational and clinical (nursing and medical) engagement it is envisaged there is an opportunity to forge relationships, and by bringing in the voice of the patient to provide a level of scrutiny and focus.

How is your project going to share learning?

Devise an educational strategy for the implementation, socialising and operationalising of policy and associated documents including:

•       evaluate different mediums for the delivery of transfer training; online, face to face

•       develop system wide learning and working relationships

•       further develop the role of Transfer Link Nurses

•       monitor compliance with the policy to measure success

Identify opportunities to scale up and spread to a regional level.