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Unscheduled Care Winter Workshop 2013/14 Winter Analysis & Preparing for Winter 2014/15. Stirling Management Centre 11 Sept 2014. Unscheduled Care October to March. Sources: ISD A&E datamart; ISD SMR01. A&E performance (%) & waits over 12 hours weekly, Nov to Mar.
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Unscheduled Care Winter Workshop2013/14 Winter Analysis & Preparing for Winter 2014/15 Stirling Management Centre 11 Sept 2014
Unscheduled Care October to March Sources: ISD A&E datamart; ISD SMR01
A&E performance (%) & waits over 12 hoursweekly, Nov to Mar Source: Weekly management information submitted to Scottish Government
A&E performance (%) Source: ISD A&E datamart
Delayed Discharges Delayed Discharges over 4 weeks (including Code 9) Bed Days Lost to Delayed Discharge
Norovirus Source: HPS
Flu – within normal threshold Source: HPS
TTG – waits over 12 weeks (seen) Source: ISD Waiting Times Warehouse
Cancer 62 day standard (%) Source: ISD Cancer Waiting Times Warehouse
Increasing Workforce Source: ISD
Preparing for Winter Guidance 2014/15 • Winter planning supports delivery of LUCAPs • DG H&SC / CEO NHS Scotland Letter to NHS Boards (19 Sept 2014) • Self-Assessment Checklists (Annex)
Self-assessment checklists • Resilience • Unscheduled/Elective Care • Out of Hours • Norovirus • Seasonal Flu • Respiratory Pathway • Mgt Information • Sign-off • Integration of Key Partners / Services
Festive Key Messages • 2 x 4 day festive periods (25-28 Dec / 1-4 Jan) • Respiratory & circulatory care • Planned activity & capacity, including social care capacity • Staff rotas over festive periods • Senior clinical decision making capacity – Discharge • Escalation / surge plans (Staffing) • Seasonal flu – staff (50% min) / public vaccination • Business continuity • Staff / public communication plans
Priorities – Now & Winter Emergency (Medical & Surgical) & elective capacity planning & management Whole hospital realignment/re-booting strategy
SITE/SECTOR CAPACITY/FLOW BASIC BUILDING BLOCKS Number of Beds Hospital at Home Number of Staff per 100 attendances, by grade D O W N S T R E A M Number of Beds ED Delayed Discharge R E C E I V I N G Or what other design/ flow? Number of self and 999 attendances Number of G.P. referrals. Clarify who makes and receives the calls? LDP Number of Cubicles Separate and dedicated minors flow Yes/No Integration Plan Rehab Discharge/ Transfer Average numbers per day/annual to each destination Assessment Unit(s) & What purpose? Number of Direct Admission planned/ unplanned Open 24/7 ? Home Discharge Lounge Number of Staff per 100attendances by grade Number of Beds/Cubicles Boarding Other Flows
Engage & empower local clinical & non-clinical teams • Professional & managerial leadership around: • Pre-noon and weekend discharge rates • Ward transfer processes
Recruitment & Retention strategy now for current, February & August gaps – act now (local, regional & national) • Delayed Discharge numbers yes, but also bed days lost to Delayed Discharge and patients awaiting care packages in the community.