Transcript Preparing for Winter 2010/11

Preparing for Winter 2011/12
Guidance Overview
Stuart Low
Planning Manager
Scottish Govt
NHSScotland Business &
Performance Mgt Team
2010/11 NHSScotland Winter
Review
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NHS Boards experienced similar
challenges and pressures to 2009/10.
Key challenges:
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Balance emergency & elective activity.
Manage patient flow from admission through
to discharge.
Efficient utilisation of capacity & optimisation of patient flow:
Priority Actions
1
Agree and test escalation policies.
2
Undertake detailed analysis and planning to effectively schedule elective
activity (both short and medium-term) based on forecast emergency and
elective demand, to optimise whole systems business continuity.
3
Agree staff rotas for the festive period in November to match projected peaks
in demand.
4
Optimise patient flow by implementing Estimated Date of Discharge as soon as
patients are admitted or scheduled for admission with supporting processes to
proactively manage discharge at regular intervals throughout the day.
5
Ensure Consultants are available to discharge patients over weekends and the
festive holiday period.
6
Agree anticipated levels of homecare packages that are likely to be required
over the winter (especially festive) period.
7
Utilise Rapid Response Teams of multi-disciplinary professionals to facilitate
discharge.
8
Ensure that communications between key partners, staff, patients and the
public are effective and that key messages are consistent.
1. Agree & test escalation policies
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Clear thresholds and
authorities for triggering
& standing down.
Sustainable resourcing,
encompassing full use of
beds in community
hospitals.
Take into account likely
impact of admissions on
elective work.
2. Analysis & planning to schedule elective
activity & optimise business continuity
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Use structured analysis, tools
and metrics to manage
variation around electives.
18 Weeks RTT due for delivery
on 31 Dec 11. Important to
pre-plan & model elective
activity to minimise disruption.
98% 4 Hr A&E Emergency
Standard continues to be
important for patient
outcomes.
3. Agree staff rotas (in Nov) to match
projected peaks in demand
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Anticipate & plan Consultant
cover to manage predicted
activity by end of Nov 11.
Take into account predicted
peaks in demand and match
resource accordingly.
Any plans to reduce number of
hospitals accepting emergency
admissions should be clearly
communicated to partner
organisations.
4. Optimise patient flow by implementing
Estimated Date of Discharge as soon as
patients are admitted
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Discharge planning should commence at the point of
admission / pre-admission assessment.
Embed traffic light systems to proactively prepare for
discharge.
Regular (daily) multi-disciplinary team ward rounds &
bed meetings.
Use predictive data to help schedule discharges to
maintain optimisation of patient flow.
5. Ensure Consultants available to discharge
over weekend’s and festive holiday period
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Ensure Medical Consultant
cover to perform dedicated
discharge rounds.
Support Nurse Led Discharges
where appropriate.
Ensure that key partners can
provide pharmacy, transport &
social care services to support
discharge process.
6. Agree anticipated level of homecare
packages, likely to be required.
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Ensure availability of care
packages to meet predicted
demand (especially over the
festive holiday period).
Early, ongoing & detailed
engagement with local social
care partners is essential.
NHS Boards & local authorities
should have joint escalation
plans / approaches to resolve
issues.
7. Utilise ‘Rapid Response Teams’ to
facilitate discharge.
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RRT of multi-disciplinary professionals, with
access to homecare packages, should be used
wherever possible.
Take discharge requirements of patients
receiving treatment at GJNH into account.
Ensure that patients at high risk of admission
are identifiable on contact & that processes are
in place to prevent admissions where possible.
8. Ensure that communications are effective
and that key messages are consistent.
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Shared information across key partners
should include:
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Key contacts
Level of service cover
Bed states
Decisions taken outside of agreed
arrangements.
Communications with the public, patients &
staff should use all available mediums.
NHS 24 leading on 2011/12 ‘Be Ready for
Winter’ campaign.
Get Ready for Winter Week
(24-30 October 2011)
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Raise awareness of winter risks
and their consequences.
Highlight steps people can take
to reduce and manage these
risks.
Provide information, resources
& support available across a
number of sectors.
Ready Scotland Website
Important Factors to Consider
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Implement norovirus outbreak
control measures.
Out of Hours self assessment.
Seasonal flu, staff protection
and outbreak resourcing
Use of management
information.
NHS Board resilience.
Signing off Winter Plans
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Opportunity to provide feedback on draft guidance
at Regional Winter Planning events.
Final version issued to Chief Execs – early October.
NHS Boards expected to implement Priority Actions &
address other important factors.
No requirement to submit winter plans to SG H&SC
Directorate.
Chief Execs should:
 discuss winter plans at Oct / Nov Board meeting.
 personally sign-off and publish plans by end Nov.