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NHS Fife

NHS Fife. Winter 2010-11. Preparation . Winter plans in place in each part of system Joint escalation procedure agreed and in place Agreement on information to be shared across the system . Blue admissions Pink discharges. Month 1. What significant changes did we note

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NHS Fife

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  1. NHS Fife Winter 2010-11

  2. Preparation • Winter plans in place in each part of system • Joint escalation procedure agreed and in place • Agreement on information to be shared across the system

  3. Blue admissions Pink discharges

  4. Month 1 • What significant changes did we note • Decrease in nursing home placements (29 v 44 from hospital and 59 v 99 in total) • Increase in delayed discharges ( total &>6 wks)

  5. Blue admissions Pink discharges Amber Boarding bed days

  6. Month 2 • What significant changes did we note • Continued decrease in nursing home placements • Continued increase in delayed discharges ( total &>6 wks) • Increase in boarding bed days • Wards closed due to Norovirus • Cancelled operations due to lack of beds • Decrease A&E performance – 98% to 92 % , Increase in 12 hour breaches from 1 to 9 in week

  7. Month 3 • What significant changes did we note • Increase in nursing home placements • Wards closed due to Norovirus • Reduced number of cancelled elective operations due to lack of beds • Reduced numbers of admissions during severe weather • Increasing boarding bed days • increase in delayed discharges >6 weeks • Severe weather -2 weeks • Unfunded beds opened across system • Overall System at Red Status • Decrease A&E performance – 92% to 89% , Increase in 12 hour breaches to 23 in week

  8. Month 4 • What significant changes did we note • Wards closed due to Norovirus • Increased number of cancelled elective operations due to lack of beds • Variable boarding bed days • Significant increase in delayed discharges >6 weeks • Additional investment from Health and Social care • Decrease A&E performance – 89% to 86% , Increase in 12 hour breaches to 37 in week

  9. Month 5 • What significant changes did we note • Significant Increase in nursing home placements • No Wards closed due to Norovirus • Significant increase in nursing home placements • Increased number of cancelled elective operations due to lack of beds • Decreasing boarding bed days • Significant decrease in delayed discharges >6 weeks • Overall status between amber and red • Increase A&E performance – 86% to 94% , decrease in 12 hour breaches to 11 in week

  10. Month 6 • What significant changes did we note • Increase in nursing home placements • Wards closed due to Norovirus • Reduced number of cancelled elective operations due to lack of beds • Significant decrease in total delayed discharges • Closure of unfunded beds • Decrease in nursing home placements • Overall status amber by middle of March • Increase A&E performance –to 94%, decrease in 12 hour breaches to 5 in week

  11. Review • Difficult winter in contrast to success in previous year • System under significant pressure from early November • Exacerbated by severe weather end of November into early December • Inability to discharge patients in timely manner from acute and community hospitals • Emergency admissions similar to previous years but increase in proportion due to falls and fractures

  12. Key areas • Significantly reduced ability to discharge to residential care and home care due to demand overtaking available resources- both financial and staff • Severe weather during November and December 2010 impacting on patients ( e.g. increased fractures and falls) and staff (e.g. transportation) . • Concern about the process for making decisions to resolve issues around patient flow

  13. What are our plans for 2011-12 • Table top exercise with Senior Management team and Partnership Management Group to test escalation procedure (August 2011) • Contingency plan being developed in event of major incident during move to new hospital • Opportunity to introduce new models of care and enhance intermediate care systems as part of change fund proposals.

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