The Continuous Flow Model: A New Approach to Hospital Management
Since 2022, hospitals across the UK, including the Norfolk and Norwich University Hospital (NNUH), have been implementing a new way of working called the Continuous Flow Model. This model aims to address the increasing challenges faced by hospitals in managing patient flow, particularly in the Accident and Emergency (A&E) department.
The Continuous Flow Model involves sending patients from A&E to wards and other areas even if they are full. This approach is a response to the soaring ambulance waits outside A&E as paramedics struggle to offload patients. The model was first introduced at the North Bristol NHS Trust before being adopted by the 10 hospitals with the most delays, as identified by NHS board papers.
According to these documents, at least 36 hospitals have now adopted the Continuous Flow Model or a variation of it. Some hospitals are “drip-feeding” patients from A&E to manage the influx. While this approach may involve placing patients on beds in corridors, it is done in a planned and risk-assessed manner.
Hospital trusts have reportedly adopted the Continuous Flow Model reluctantly, but they acknowledge that it has resulted in quicker access to care for the sickest patients brought in by ambulance. Lesley Dwyer, the chief executive of NNUH, emphasized the importance of reducing ambulance delays outside the hospital to improve response times and save lives in the community.
Nick Hulme, the interim chief executive of NNUH, highlighted the trade-offs involved in implementing the Continuous Flow Model. While ambulance handover delays have been reduced, the risk has been shifted from outside the hospital to corridors within the facility. Hulme believes that this shift is ultimately better for the community, as it allows ambulances to reach patients in need more quickly.
The adoption of the Continuous Flow Model represents a significant shift in hospital management practices, with a focus on improving patient flow and reducing delays in accessing care. While the model may present challenges in terms of bed capacity and patient placement, hospitals like NNUH are committed to finding innovative solutions to ensure timely and efficient healthcare delivery for the benefit of their patients and the community at large.
