Ronald Bennett

Dear Miss Tisshaw The late_Mr Ronald Bennett,DOB: 05/05/1935 Thank you for your letter of 4 April 2017 addressed to_ Trust Managing Director. You may be aware that Marianne Griffiths has since become Chief Executive of Brighton and Sussex University Hospitals NHS Trust (BSUH) and am replying on behalf of Ms Griffiths_ am very sorry to read about the sad circumstances of Mr Bennett's death and the concerns which you have highlighted about the Trust's Emergency Department and lack of availability of inpatient beds: These issues have been reviewed by the Clinical Lead for the Emergency Department;, the Clinical Director for Acute Floor and by our Interim Chief Operating Officer. We recognise that since February 2016, the Trust; in common with NHS services in the rest of the country, has had difficulty in complying with a range of emergency care performance measures and national standards. Specifically, the problem of delays in ambulance staff able to hand over patients to the Emergency Department at the Royal Sussex County Hospital (RSCH) has been caused by overcrowding in Department: This has been compounded by lack of bed availability for patients who need to be admitted. Bed availability is in turn linked to delayed transfer of patients medically ready for discharge, who are waiting for packages of care in the community or a residential setting: Since January 2017 , there have been significant efforts to work more closely with South East Coast Ambulance Service NHS Foundation Trust (SECAMB) and this has been reflected in improved ambulance handover performance. In March 2017 the ambulance handover performance was the best for two years_ The following actions are also ongoing in order to improve patient flow and reduce overcrowding in the Emergency Department: (1) Local Authorities in England have been granted a budget increase of E1bn for 2017-
18. The details of how this will be deployed locally are still worked out but we anticipate this will have a significant impact on improving delayed transfers of inpatients_ With our partner brighton and sussex medical school the being the being

(2) We are working with NHS 111 on our Directory of services to ensure patients are directed to appropriate services other than the Emergency Department (3) We now have E31m capital scheme in development to expand the emergency floor, including an expanded Urgent Care Centre at the Royal Sussex County Hospital, more GP input to the Emergency Department and an ambulatory emergency care facility in advance of next winter. (4) The Trust's Clinical Transformation Programme includes the following measures: A review of service provision at Princess Royal Hospital, Haywards Heath, to further relieve pressure on bed capacity at the RSCH Implementation of the SAFER care bundle (this is a range of interventions aimed at improving patient flow and discharging patients earlier in the day) iii_ Creating more discharge capacity by expansion of Newhaven Downs Community Hospital and extending the scale of the Hospital at Home scheme (where patients discharged home received extended nursing and medical input) As part of the development of closer working relations with SECAMB, the two organisations have agreed and implemented a new clinical handover protocol and escalation triggers at 15_ 30 and 60 minutes from arrival of a patient to ensure more timely handover. The Trust is also funding the joint appointment of a Hospital Ambulance Liaison Officer and we have commissioned an observational audit of the handover process to identify any further improvements that can be made hope that the above information is helpful and thank you again for raising your concerns with the Trust: would also be grateful if you could pass on my condolences to Mrs Bennett for her sad loss hope my letter will provide assurance to Mrs Bennett that the Trust is committed to doing everything possible to address the issues identified during the inquest_