Upwards of 11,000 bed days have been freed up in NHS Greater Glasgow and Clyde hospitals so far this year thanks to an innovative service which helps keep patients out of hospital.
The Outpatient Parenteral Antibiotic Therapy (OPAT) service supports early discharge for patients with complex infections, who would otherwise require a long hospital stay, and provides an alternative to hospital admission for patients with other conditions requiring a shorter stay such as cellulitis or complicated urinary tract infection.
Discharge with either intravenous or complex oral antimicrobial therapy is supported from all hospitals within NHSGGC by the main OPAT service which is based at the Queen Elizabeth University Hospital (QEUH) in Glasgow.
A cellulitis admission avoidance service is also provided for patients via the Queen Elizabeth University Hospital and more recently from the ambulatory care centre in Inverclyde Royal Hospital.
The OPAT service is currently expanding with the aim of supporting earlier discharge and more locally delivered admission avoidance services via ambulatory care centres throughout NHSGGC. The service is contributing to between 350 to 400 avoided inpatient days for upwards of 70 patients per week. Numbers are growing every month as the service takes on new staff and works with local ambulatory care teams to help deliver the treatment.
The Royal Alexandria Hospital ambulatory care service will soon be offering an OPAT cellulitis admission avoidance service also and the QEUH based service is set to move to a seven day service and meaning even more patients will benefit.
Dr Andrew Seaton is a consultant in infectious diseases and leads the OPAT service across NHSGGC. Dr Seaton said:
“In simple terms, OPAT helps keep people with a range of infections out of the hospital who are usually admitted (or stay in) because they need intravenous therapy. Keeping people out of hospital benefits patients and their families as they can remain at home without any of the anxiety and risks involved with being an in hospital and it benefits the health service overall, as it allows for the most appropriate use of our inpatient facilities. OPAT relies on good multi-disciplinary team work and we are extremely lucky in NHSGGC to have an excellent team of specialist nurses who deliver really high quality patient centred care. Our recent experience with working with ambulatory care teams in Inverclyde has also been crucial to the success of this rollout, and we very much hope we can replicate this across other parts of our health board.”
Dr Scott Davidson, Deputy Medical Director for Acute Services at NHSGGC added:
The COVID-19 pandemic and current pressures on acute hospital services have highlighted the need to provide an alternative to treatment in hospital settings wherever possible. OPAT is a great example of how collaborative working and thinking between teams allows patients to be managed safely on an outpatient pathway rather than having to be admitted to hospital. It also creates significant inroads in helping reduce capacity on acute services. The initial figures are very promising and we’re excited to see the longer term impact on our acute service as OPAT continues to grow and is able to see more patients each month.”
CASE STUDY: Caroline McNaughton, 61
Cellulitis is an infection of the deeper layers of skin and the underlying tissue. It can be serious if not treated promptly with approximately 1600 patients admitted to hospital for up to one week in NHSGGC per year. The condition is far more common in summer months when warmer weather brings higher chances of being bitten by insects such as midges, which can cause the condition to flare up.
For patients such as Caroline McNaughton, 61, who has suffered acute bouts of cellulitis ever since mysteriously being bitten on holiday more than eight years ago, it has been a huge relief and means she has avoided lengthy waits in A&E during the pandemic.
Retired classroom assistant, Caroline, said: “Any other time I’ve had cellulitis I’ve had to come to A&E and wait in busy waiting rooms before being taken in for treatment. The first time I had to stay for a whole week to get my course of antibiotics.
“This time around, I got referred to the clinic and was on antibiotics within the hour. I’ve gone down every day since then for a scheduled appointment. It’s less stressful, more reassuring and you’re seen much faster.”
ENDS
More information and Scotland-wide figures available at: opat-update-on-progress-in-scotland-august-2022.pdf (sapg.scot)
NHSGGC breakdown as follows
| GGC – Jan 2022 | Days | Patients |
| week 1 | 284 | 51 |
| week 2 | 278 | 49 |
| week 3 | 276 | 49 |
| week 4 | 303 | 52 |
| week 5 | 300 | 51 |
| week 6 | 329 | 55 |
| week 7 | 359 | 61 |
| week 8 | 386 | 68 |
| week 9 | 337 | 56 |
| week 10 | 339 | 53 |
| week 11 | 367 | 62 |
| week 12 | 337 | 61 |
| week 13 | 358 | 59 |
| week 14 | 368 | 60 |
| week 15 | 417 | 68 |
| week 16 | 258 | 48 |
| week 17 | 281 | 50 |
| week 18 | 335 | 54 |
| week 19 | 321 | 60 |
| week 20 | 314 | 52 |
| week 21 | 319 | 55 |
| week 22 | 358 | 61 |
| week 23 | 339 | 57 |
| week 24 | 356 | 60 |
| week 25 | 394 | 67 |
| week 26 | 408 | 74 |
| week 27 | 353 | 65 |
| week 28 | 356 | 59 |
| week 29 | 402 | 71 |
| week 30 | 404 | 70 |
| week 31 | 407 | 72 |
| week 32 | 368 | 67 |
| week 33 | 358 | 61 |
| 11,369 |