Acute Upper GI Bleeding Provision: Painting a Picture of Mersey

Dr Howard Smart

Consultant Gastroenterologist

Royal Liverpool University Hospital

AUGIB in Mersey: Overview

• Demographics

• Location of Trusts

• Provision for Acute Upper GI Bleeding

• Examples of Good Practice

• Barriers to Service Provision

AUGIB in Mersey: Demographics

• Merseyside – 250 Square Miles

– Pop. 1.38 Million

• Old “Mersey Region” – In addition includes

Cheshire • 900 Square Miles

• Pop. 1 Million

– Chester

– Crewe

– Macclesfield

– Warrington

RLUH (14) 7 Day Working Weekend Lists

OOH Rota

UHA (8) 7 Day Working

OOH Rota

Wirral UHT (8) 7 Day Working Weekend Lists

OOH Rota

St Helens & Knowsley

Whiston (7) 7 Day Working Weekend Lists

OOH Rota

Warrington & Halton

(4) 5 Day Working

OOH Rota

Countess of Chester (5) No OOH Rota

Mid Cheshire Hospitals Crewe (3)

No OOH Rota

East Cheshire NHS Trust

Macclesfield (2) OOH Rota

Southport & Ormskirk

NHS Trust (2) No OOH Rota

AUGIB in Mersey: Embolisation Provision

RLUH, UHA, STH&K

WUHT, COCH, S&O

Crewe, Warrington, Macclesfield

AUGIB in Mersey

Good Practice

• Major Trusts have implemented Gastroenterology On-Call, 7-day working & OOH Rota

• Act as referral centers

• Surgeons can help

• Arrangements with neighboring provider

Barriers

• Lack of Consultant numbers

• Heavy commitment to GIM

• Lack of Surgical co-operation

• Lack of networking between Trusts