Improving hospital handovers In September we hosted the last of our programme of hospital handover improvement events to mark the end of our 90 day improvement programme with 11 hospital trusts across the region. Colleagues from Aintree, Arrowe Park, Royal Liverpool, Southport, Warrington, Whiston, Blackburn, Lancaster, Preston Royal Bolton and Stepping Hill have all taken part in the improvement cycle with support from NHS Improvement and the Emergency Care Improvement Programme. Local representatives from the ambulance service have worked with individual hospitals to introduce small scale tests of change using the ‘plan, do, study and act’ (PDSA) cycle to measure, refine and develop improvement solutions. At the end of the programme, an impressive 10 of the 11 trusts involved have improved emergency department handover times giving patients a better NHS experience. A common theme from all improving trusts was the need to take ownership of handover times and accept that the patients are their responsibility as soon as they arrive at the emergency department. The biggest improvers - Royal Liverpool – have reduced lost ambulance hours by 69%. Key to this change was the introduction of a senior nurse to do primary triage of all ambulance patients. They are also testing a frailty streaming tool with ambulance patients to keep vulnerable older people out of the emergency department. Check out NHS Improvement’s Good practice guide: Focus on improving patient flow which contains specific advice relating to ambulance handovers in emergency departments.