Poole hospital Urgent Care Service. A young perspective By Chloe Lovell and Demi Watts

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1 Poole hospital Urgent Care Service A young perspective By Chloe Lovell and Demi Watts

2 Methodology Our job as young inspectors, based in Dorchester, is to inspect the local services in Dorset for the young adult community and to see how appealing they are to us as young people. On our visit to the Poole urgent care service, we aimed to evaluate the way that young people are treated there. We participated in interviews with the staff around the department and had a tour. We filled out grading sheets for the environment, including accessibility, posters and information for young people and the general attitudes towards young people.

3 Website research We researched 'NHS Poole out of hours' it gave us lots of results, there was a generic website giving us an idea about out of hours. However, we couldn't find anything specific to Poole. This was a shame, as this lack of information did not help us in the areas of transportation, map of the hospital, where I should go, or the people I should talk to on arrival. The only information found was a small sentence on the web site page giving us information on the central telephone number. As well as this, we found two feed back sites which is a site where patients can write their experiences, opinions and their views. One was run by the NHS; it was very interesting because people had voted on what they thought about Poole out of hours and the data was collected and then shown as a rating.

4 Results This is what we found from; Interviews with staff Observations; Inside Outside Entrance Posters Leaflets Toilets

5 Leaflets and Posters In this department there weren t many posters. However there was one display of posters and it was very bright which would encourage people to look at it as it stood out from the boring plain white walls. To the left of the display they had a leaflet stand which was full of Cancer Research information that you can take away with you. Also in the toilets they had a large stand of sexual health information. I think this is really good because it means people can take information without other people seeing, as it might be personal.

6 Entrance Outside of the 'Out of Hours Department At the entrance to the Out of Hours Department there were clear signs letting you know that you had arrived at the department. This sign was very clear, bold and colourful and it did make itself known. However, I think It would have worked better if this sign was hung at eye level, as some elderly patients, or the disabled might not be able to see it. On entering the department we were greeted with a stand of variety of information that put forward support around subjects that you might see at your local GP, such as information on cancer, drugs, Your NHS, epilepsy and Medical Alert. There was also local information on activities within the area. We viewed this area as clean, tidy and spacious. The staff were friendly and they smiled at us as we walked in. This made us feel safe and welcomed. The staff appeared smart, but tired. This could reflect their working day, but we do need to highlight that the department was constantly in use, but it wasn't chaotic, and it seemed very well organised. The only confusing aspect of this department was the fact that it was right next to the café and the doors to both entrances were very close together. Also, the opening times to the café could have looked as if they were showing you the times for the Out of Hours service.

7 Toilets We found that the toilets were tucked away and quite hard to find. There were signs directing you to the toilet, but these were too high and very small, so quite hard to see. We did ask the staff and they were very helpful with their directions. There was not a disabled toilet near the others but there was one down the hall. This was convenient for all as it was in easy reach of the department. There were two male toilets and two female toilets which we feel is enough for the number of patients. One very positive aspect of the toilets which we were very pleased with, was the fact that there was 'Sexual Health Information' that people could discreetly pick up. However, the men s toilets were not quite as equipped with information, although they did have a smaller, but a good selection of leaflets.

8 Inside The general atmosphere of the department was good although quite loud for a small department. It appeared well presented and spotless. This gave us the feel that the department was well cared for which in turn made us feel comfortable. The one display they had was very informative, bold and colourful. This was easy to see from afar, but there could have been more of these displays around this area as it would have brightened the wall up a little. This setting was seen as simplistic, and accessible for anyone using a wheelchair. We could not see any entertainment for children and young people, but the staff did state that their services were not here on a permanent bases which made this area difficult to make their own and adapt to the 'Out of Hours' they would like to have. There were magazines provided for the general public, but we feel that due to the short waiting times that this wasn't really very necessary, but it was a nice touch. The sense of space was particularly good as we felt that patients did have many choices regarding their seating area and their location. There were no recycling bins but there were some normal bins in the entrance. The amount of safety signs around the department was very good as they were in each room. As the urgent care service isn t placed permanently here, there were no comment boxes.

9 Staff interviews When we interviewed the two members of staff chosen from the out of hours clinic they were very busy and looked tired. They had been working in the department for 8 years and 7 years and said that they were very happy there. When we asked them what s the hardest part of your job? The first member of staff replied staffing the department and keeping on top of the patients that use the service.. The second replied people time management and telling patients there is nothing wrong with them and they should see their GP. When we ask them what would make your job easier? One member of staff said that more nurses working in the out of hours clinic would be a lot easier and would make things flow a lot quicker and the second said better equipment and more equipment. We were told that staff do not have to do training on how to communicate with young people. They both said that they can feel overwhelmed by the stress of the job.

10 They mentioned that there was always someone they could talk to about anything that had happened at work, or had happened as a result of their job. We were told that all staff were respectful to other staff members and patients. We also asked if there were comment boxes in the department and we were told that as the department was not temporary they could not put any up. They told us they do give out questionnaires to the patients to receive feedback on what they have done correctly and what could be improved on. They told us they get very positive feedback from patients, with 98% satisfaction. The waiting times in the eyes of the staff are adequate as they are pre-booked and they are arranged before the patients come to the clinic. The longest waiting time is an hour and a half. They don t get complaints about the waiting times.

11 They both feel they are providing the best they can for patients. What do you think of the new 111 service? Our first member of staff said it will simplify things, help the flow of patients and help educate people. The second said that it should work well but they are concerned that it could increase the work load of the A and E department. When asked what they would do to improve the NHS? The first member of staff said they would educate the public, stop cutbacks and ensure less abuse of NHS staff. The second one said they would educate patients to ensure they go to the right person, at the right place and at the right time. Under our working with young people section we asked if they talk to children and young people in a way they will understand? They both answered with a yes. We were told they hardly ever get young people accessing this service due to issues from binge drinking, as they go to A and E. One of the members of staff told us they don t hear much about binge drinking being a problem in this area. We asked if they know all the facts about a young person so they don t tell them the wrong information or give them the wrong medication. We were told that they do not have any access to medical records unless they have been to the A and E department before so they have to go by what they are told.

12 They both told us that young people haven t been abusive towards them. One of them told us that if this did happen, they would find out why they are acting up. We were also told that there is no one to help young people in the waiting room, but its not entirely needed as most people accessing the service are between 2-5 or above 25 years old. One staff member felt that training in how to deal with young people isn t essential as most patients are 2-5 years old or 25 or over. The other believed that training in how to deal with young people would be useful to have and role play training would be good, exploring depression, alcohol and drugs. They felt a programme with or run by teenagers would be good. We asked what would you do if a young person has a suspicious injury? The first member of staff replied that she would ask very carefully and find out their age and the circumstances. They would try and keep them in the paediatric ward and contact social services. The second member of staff said that she would refer to social care. What would you do to reassure and comfort and young person? One said they would explain clearly what they will do to help and answer any questions. The other replied they would talk and empathise with them.

13 When we asked how many young people they see, they were unsure but one said hundreds and it is more than A&E as they receive patients from Swanage to Bournemouth. We found that both staff said they treat all young people with respect and they don t treat young people differently to adults. They both agreed there isn t anything for young people to do whilst they are waiting. One went on to say they can bring in a book and commented that they aren t there to socialise. We asked them what they would do to improve the NHS for young people. The first staff member said they would create a teenage area and a teenage ward for the hospital (14-19). The other person said a young person clinic or drop-in.

14 Conclusion Overall, I was very impressed with this this service. The staff were very smiley, friendly, happy, but extremely busy. We felt welcomed to this department. There was plenty of up to-date information, posters and leaflets and we appreciated the privacy given to patients when taking into consideration the leaflets on sexual health in the toilets. I think they do very well considering they aren t permanently based in this building and I appreciate that this could also make it difficult for them to implement any recommendations this report makes. I really liked that the out of hours was comfortable, busy, but not chaotic. There was quite a calm and organised atmosphere. It had a homely feel to it and it made me feel safe. We didn't feel restricted in the space and it felt good to choose our seating area as you could keep yourself to yourself as there was ample seating options. The area was very clean and tidy and I didn't worry about germs. This made me feel relaxed and if I had been a patient at that time, I think it would have helped me to trust in the staff

15 Recommendations Based on my observations and the staff interviews, here are the recommendations I feel would make the Urgent Care Service better for young people; Entertainment is needed for children and young people as this will make it less fearful for them if they are ill and bored. Recycling bins are needed around this department as this would encourage an eco friendly hospital. We would like to see some sort of comments box. We feel that even a portable one would make sense. Even though the toilets were clean, it would be very good to see a cleaning rota, so patients know when it was last cleaned and who cleaned them. Better signs at eye level for the toilets. Moving the sign at the entrance to the Out of Hours down to eye level so it can be seen more easily.

16 Recommendations continued.. We would also recommend that the staff have training on how to communicate with children and young people. To voice on behalf of the Staff Nurse, we would also like to ask for better and more equipment for their service. More staff needed when busy. Another recommendation put forward by another Nursing Staff was to have a teenage ward only. This ward would accommodate teenagers between the ages of fourteen and nineteen.

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