Item 5 for 1 Dec 09 Winter Plan

NHS Grampian

Winter Planning 2009/10

Introduction

Whole system Winter Planning has now entered its third year, building on previous experience, greater integration and a better understanding of cross system working. Throughout the previous 12 months NHS Grampian (the CHPs, Acute Sector, Out Of Hours service, A&E, Primary Care, and others) have planned jointly with partner agencies to ensure a robust service provision during the high demand winter period.

With the advent of Pandemic Flu H1N1 and the need for a mass vaccination programme, a greater emphasis has been placed on planning for increased patient demand and reduced staff / service capacity.

During this year’s National Winter Planning meetings at AirthCastle and Dunfermline on 16th June and 23rd September 2009,NHS Grampian presented 3positive initiatives(bed management meetings, ensuring consultant cover and integrated working with Local Authorities) in response to Dr Dan Becket’s Report on Review of Board performance for period November 08– April 09.

Again, Territorial Health Boards are asked to give thisyear’s winter planningprogramme priority, ensuring whole system plans exist. Written guidance was issued by the Scottish Government Health Directorate (SGHD)on 11thSeptember 2009and a self assessment was completed and returned on 16thOctoberto ensure that the plan meets the guidance criteria.A review of our self assessment submission highlighted many areas where the SGHD were pleased to note positive actions (supported discharges, system watch and integrated working with Local Authorities) and only one area for further action regarding untriaged call predictions/ activity. Due to the very sporadic nature of the current H1N1 outbreak, accurately predicting activity is proving extremely difficult.

CHP, Acute Sector, various departments and partner organisations’ Winter Plans, Business Continuity Plans, Escalation Policies, Pandemic Flu, Mass vaccination plans and Prioritisation documentsare being compiledinto a working suite of documentsthat constitutes the NHS Grampian Winter Plan 2009/10.

Access to the plans is available via hyperlink

Aim

To produce a working Winter Plan 2009/10 document in partnership with all internal and external stakeholders.

To ensure that the NHS Grampian Winter Plan 2009/10 promotes a whole system approach and provides assurances that patient care and experience are not compromised throughout the winter period, while maintaining all performance objectives.

To promote enhanced networking opportunities between departments to ensure a greater understanding of impact on whole system performance.

Discussion

Development of the 2009/10 Winter Plan has involved a great deal of work including:

Significant use of Out Of Hours, NHS24 Simul8 data, SPARRA (Scottish Patients At Risk of Readmission and Admission) data, predicted surge demand over festive period
Advanced workforce planning, managing annual leave and integrated working with partners
Converting unscheduled care into planned care: requesting general medical practices to maximise on-the-day appointments over the festive period.
Maximising capacity at high demand periods.
Alternatives to Admission;Referral Management, Bed Management Policy
Managing elective capacity in the Acute Sector

Unplanned/ Activity/ Escalation

Surge demand, acknowledge and plan for activity (festive period)
Prioritisation Documents have been developed and Escalation plans have been updated for all Sectors, trigger points identified and communications in place with partners
Unknowns, Flu pandemic plans, adverse weather plans and business continuity plans are in place.

Position to date

The Winter Planning working group has been meeting regularly to develop the NHS Grampian Winter Plan 2009/10. The Winter Plan is a live working document that will continue to be updated and amended as necessary. Maintaining the momentum from previous years is key to success. Regular meetings throughout the winter period are planned to maintain communications with partners, monitor activity and review performance.

Increased whole system planning activity has taken place as a direct result of Pandemic flu outbreak.
Advanced systems in place for the collection of activity data, monitoring performance and exception reporting.
A greater use of historical activity data to predict future demand both short and long term.
Resourcing levels balanced with predicted activity with contingency plans to cope with surge demand.

Key Risks

This year we are facing the possibility of a second wave of pandemic flu as well as the likelihood of significant extra pressures in relation to delivery ofthe influenza A (H1 N1) vaccination programme.
As in previous years, the key risks are sudden significant increase in viral illness, seasonal flu (high risk) and severe weather (medium risk).
Staff fatigue and absence due to the long protracted nature of dealing with the pandemic flu outbreak.
Infection control measures are in place to prevent Healthcare Associated Infection. Risk control and contingency plans are in place.

Conclusions

NHS Grampian has enthusiastically embraced the winter planning process. Winter Plans have been reviewed and updated taking account of the increased numbers of patients expected as a result of the pandemic Flu H1N1. Plans are in place to address issues as a result of predicted winter period demand and mass vaccination programme.

Recommendation

The Board is asked to note and be assured of NHS Grampian’s preparedness for the winter period.

George McLean

General Manager

G-MED OOH Service

DavidAndersonBuilding