TEES VALLEY HEALTH SCRUTINY

1. TEES VALLEY HEALTH SCRUTINY WINTER PREPAREDNESS 10 OCTOBER 2011 Celia Weldon, Director of Corporate Development Peter Kelly, Executive Director of Public Health Toks Sangowawa, Clinical Director of Public Health

2. Winter pressures What plans does the local NHS have in place to deal with any additional pressures on services that come from issues associated with seasonal flu? This includes inpatient beds, as well as other non-inpatient services? All provider organisations (STFT, NTFT, TEWV and NDUC) have a Winter Assurance Frameworks, a North East Escalation Plan (NEEP) and a Flu Plan. All provider organisations have presented these plans to their Boards for approval in September 2011 NHS Tees maintains the system NEEP for Tees

3. Provider Mutual Assistance To what extent do hospital trusts have ‘mutual assistance’ agreements to maximise any spare bed capacity should it be needed due to winter pressures? There is a mutual aid process between NHS organisations which has been in place since 2010 and is currently being refreshed, for use when: Pressures on bed capacity When an A&E department is experiencing significant pressure Can be requested at NEEP level 3 – relates to time or numbers of patients Agreed process in place and involves NEAS Ambulance Control Room

4. NEEP level 3 – Pressuretriggers Evidence of significantly increased activity across Tees. Activity is placing real pressure on organisations Actions taken at NEEP level 2 have not reduced pressure on organisations 2 or more organisations in Tees reporting NEEP level 3 Deterioration in weather conditions, or severe weather forecast that threatens to cause widespread disruption SHA identify need to regional command and control of NHS Declared major incident affecting 1 NHS organisation on Tees Note NEEP level 1 (normal) and NEEP level 2 (concern) must have been worked through before arriving at NEEP level 3

5. Role of SHA What role does the SHA play in supporting the local system to deal with winter pressures and in assuring itself of the system’s ability to respond to winter pressures? The SHA performancemanages PCTs on their winter planning arrangements Winter assurance letter 2011/12 – highlights key risks for 2011/12, mitigating actions that should be considered, NHS and social services collaboration. Critical care management and delivery and Business Continuity arrangements The SHA establishes a winter cell – SHA, PCT and critical care Support for flu vaccination campaign – staff and eligible patients Daily SITREP from November (acute, community and ambulance) Weekly vaccination uptake reports for NHS Staff

6. Success Are there any areas of concern for Directors of Public Health relating to winter preparedness? Usual concern of inadequate vaccine supply addressed Perhaps a pandemic situation, although plans in place What would a successful winter period look like to Directors of Public Health? Arrangements worked well between all NHS organisations, Local Authorities and other providers Plans put in place were utilised effectively Patient Safety and Quality of Service was not compromised

7. Flu Vaccine What steps has the NHS in the North East taken to highlight the availability of the flu vaccine and specifically target it to ‘at risk’ groups? Region & Local Communication Plans Flu fighter roadshows/Local GP champions Targeted info to ‘at risk’ groups Clinical Bulletins Flu letters to relevant ‘at risk’ practitioners/professionals

8. Resilience Do directors of Public Health feel confident that they can command the necessary resources to ensure sufficient resilience in the North East? NEEP as described earlier Regional coordinated Flu vaccination programme - monthly, then weekly teleconferences with flexibility to escalate as required Exercised Emergency Planning/Business Continuity Plans

9. Flu vaccine What sort of percentage of those eligible, taking up the vaccine would be viewed as ‘good’ take up? 75% for >65s 60% for <65s at risk incl. pregnant women 60% for frontline health & social care staff