An evaluation of the impact of High-Intensity Specialist-Led Acute Care (HiSLAC) on emergency admissions to NHS hospitals at weekends.
The HiSLAC project is funded by the National Institute of Health Research (NIHR-HS&DR Programme Commissioned call 12/128: Organisation & delivery of 24/7 healthcare).
HiSLAC is an independent, professionally-led study which will evaluate a key component of NHS England's policy drive for 7-day services: the intensity of specialist-led care of emergency medical admissions, with a particular focus on weekend provision. This research is important for patients and for NHS strategy because it offers a unique opportunity to evaluate the impact of the transition to seven-day working, and to understand factors likely to impede or enhance the effectiveness of this change in practice.
In addition to examining the impact on patient-centred outcomes, the project will also undertake a health economics analysis of the impact of increasing specialist provision across the NHS. HiSLAC will therefore provide useful information across the NHS about the cost-effectiveness of investing in consultant and other specialist staffing in implementing the drive to 7-day service provision.
The decision on award of funding was made in September 2013 and the project launched in February 2014. This website will be updated over the coming weeks and months as the project progresses.
This summer, we launch our fifth and final survey to help create a nationwide ‘snapshot’ of specialist intensity and 7-day services. The annual Point Prevalence Survey will be distributed to consultants and associate specialists, via local project leads, in mid-June.
The protocol for HiSLAC’s health economics workstream has been published in BMJ Open.
‘Protocol for the Health Economic Evaluation of Increasing the Weekend Specialist to Patient Ratio in Hospitals in England’ sets out the latest component of the five-year study.
HiSLAC’s Case Note Review protocol has been published in BMJ Open.
A Two-Epoch Cross-Sectional Case Record Review Protocol Comparing Quality Of Care Of Hospital Emergency Admissions At Weekends Versus Weekdays sets out the latest component of the five-year HiSLAC project.
The second round of HiSLAC’s ethnography sub-study has now started.
Based at the University of Leicester, the ethnographers are conducting a qualitative study to find out more about how hospitals organise systems for weekend care. Insights from initial visits and interviews at 20 case study sites are shaping the second round of work.
Due to recent bed pressures patients are often sent from the Acute Medical Unit to the wards without a consultant review, and in some cases without a registrar review.
On the wards it is 'pot luck' whether the patient is seen by a consultant the following day or a few days down the line.
Once the patient is identified under the correct team it depends on which day a consultant does their ward rounds, which means a delay up to 5-6 days.
The patient was an outlier; no one knew the patient and wanted to take any responsibility.