By 1st November 2010 Trust Executive Teams will have approved winter planning arrangements to include risks identified in DH Gateway letter 14382 Preparations for winter planning and reporting dated 10th September 2010
Winter Planning arrangements have been completed. They will be considered for approval at the Management Executive Group on 2nd November, the Professional Executive on 3rd November and at the NHSR Board on 15 November 2010. This fits in with the decision making cycle at NHSR. The plans have already been endorsed by the Emergency Care Network and Practice Based Commissioning Group.
b
Trust plans will have been shared with NHS organisations in the local health economy as well as the Ambulance Services and Local Authority/ies
Rotherham’s Emergency and Urgent Care Network meets on a monthly basis. Winter Planning is a standard agenda item where any issues can be discussed and addressed. The Rotherham Surge and Mass Discharge plan has been shared with and approved by this group. The group includes representatives from the ambulance service and the local authority.
c
Through local unscheduled care/emergency care networks agreement about where and how special arrangements will have discussed and agreed local risks and how these risks will be managed
Rotherham’s Emergency and Urgent Care Network has representation from all partner agencies across the local health and social care community. The main purpose of the group is to develop integrated and effective Urgent and Emergency Care Services and pathways across the health and social care community.
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Winter Preparedness (All Trusts)
Trust Assurance Comment The Network ensures ease of access to appropriate services in line with national standards. It aims to deliver a system wide care pathway approach to admission avoidance and discharge planning. The Network engages with external organisations whose services contribute to the effective delivery of emergency care. It works with health and social care commissioners to determine priorities, promote knowledge of developments in emergency care and agree local standards and protocols to facilitate comparative audit and training.
d
Confirmation that special arrangements for the Christmas and the New Year period are included in the above plans
2
Risk Assessments
a
The Trust has undertaken a specific risk assessment on which planning assumptions are based to ensure ‘business as usual’
Extreme weather has been identified within the emergency planning risk register. This has been fed into the corporate risk register.
b
The Trust has considered the possibility of industrial action that could impact on delivery of service and has reviewed workforce plans to ensure essential functions will be maintained. This planning should also consider fuel and other critical supplies.
Industrial action is identified within the risk assurance framework monitored by the Rotherham Community Health Services governance process. The business continuity framework also contains business specific plans to be put in place in such an emergency.
3
Business Continuity
a
The Trust has Business Continuity Management plans and has tested these plans within the last 12 months
2
NHSR collate and share arrangements for Christmas and the New Year period across health and social care. A document incorporating all rotas and cover arrangements will be produced by NHS Rotherham by 30th November
NHS Rotherham has an up to date Business Continuity Plan. The plan is tested on a regular basis. A specific Emergency Planning Exercises has taken place over
Winter Preparedness (All Trusts)
Trust Assurance Comment the last 12 months.
b
The Trust business continuity plans include: A local policy on adverse weather arrangements for both staff and patients and has local agreements in place with partners eg. Ambulance, local authority, police and voluntary agencies
Can confirm that the NHs Rotherham has a local policy on adverse weather arrangements for staff and patients. Local agreements are in place with key partners such as the Yorkshire Ambulance Service, Rotherham MBC and police foce.
c
Processes in place to ensure the timely and accurate delivery of data/information as set out by the Department of Health and the Strategic Health Authority
Processes are in place at RFT for all daily, weekly and monthly SHA and DH data/information returns.
d
Agreed protocols and metrics (an agreed health economy wide set of metrics to monitor demand in the system) are in place for the co-ordination of the health and social care economy in order to maximise the use of community hospital bed capacity and residential and nursing home bed capacity, protocols for rapid discharge arrangements and identification of vulnerable people.
NHSR is currently piloting a daily sitrep report looking at activity, performance, bed capacity, staffing issues and any effect this may be having on services. This is being done by collating information across health and social care; Rotherham Foundation Trust, A&E, Rotherham Community Health Services, YAS, WIC and GP Out of Hours. This will provide real time data to highlight any problems as they happen. Rotherham Foundation Trust has also developed a priority work plan to coordinate effective discharge planning for complex patients. Rotherham does not have a community hospital, but there is now an agreement that Breathing Space beds could be used more flexibly to aid discharge from hospital along with the Intermediate Care beds.
f
The Trust has reviewed its facilities and estates plans for maintenance of critical assets e.g. CT scanners for the winter period as well as ensuring contingencies are in place to maximum mortuary capacity.
RFT has appropriate business continuity plans in place to maintain critical assets and staffing levels and has also put plans in place with local Funeral Directors to maximise mortuary capacity. There will be the provision of CT over the bank holiday this will be for urgent acute cases and covered by the Radiologist on call service. In principle the service will be available 24 /7 over the bank holiday period. Plans have been submitted for RFT to provide
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Winter Preparedness (All Trusts)
g
Trust Assurance Comment
For PCTs Only The Trust has reviewed the GP Out of Hours service arrangements for the winter period and has assurance that contingency plans for winter are in place.
4
Vaccination
a
The Trust has a Director-level led vaccination programme to ensure the maximum possible uptake of seasonal flu and pandemic flu vaccines in priority public groups and frontline health and social cares staff as appropriate to the organisation.
additional sessions over the extra bank holidays during 2010/11. This is to increase the access to the service to prevent delays in patient management; approval for proposed funding is awaited. RFT is in possession of two CT scanners unless there is a complete disaster which takes both systems out RFT is confident that it will be able to offer a resilient service. Care UK has produced their rotas for all staff groups for this period to cover expected increases in demand over the bank holiday weekend. They also have additional doctors on standby over this period that can be called on to give extra cover. Care UK has an internal escalation plan that makes provision for routine predictable changes that are established using a forecasting system and exceptional predictable variations. Care UK also forms an integral part of the Rotherham Surge and Mass Discharge Plan for Out of Hours services.
The mass vaccination plan has been reviewed and this has been approved by the Joint Health and Social Care Emergency Planning Group and has been submitted to Board for ratification. A seasonal flu vaccination plan has been approved and circulated. The pandemic flu plan has been reviewed and is currently out for consultation.
b
The Trust has systems in place to include vaccination update data is reported onto the ImmForm system in line with national requirements within the specified timeframes
NHSR’s Public Health Department report data on behalf of NHSR staff. This function is provided by the Primary Care Contracting team at NHSR for GPs. The Foundation Trust report their own data.
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Winter Preparedness (All Trusts) 5
Escalation
a
The Trust has internal escalation processes as well as local escalation plans with partners to manage surge management and has reviewed Adult Critical Care Network escalation plans and Children’s Critical Care network escalation plans to include patient transport.
Trust Assurance Comment
The Rotherham Surge and Rapid Discharge Plan has been developed with partners to provide a whole system approach in the event of a surge. The Rotherham Accelerated Integrated Discharge process had been stress-tested by RFT and partner agencies and an action plan has been developed. RFT has robust internal Escalation Plans that have been shared with NHSR. Adult and Children Critical Network Plans are in place, including patient transport (Embrace for Paediatrics). All on call staff have been offered training in the last 12 months. All staff are aware of local escalation policy. The regional escalation process has been circulated amongst key staff.
b
The Trust has ensured that all staff with on call responsibilities have an up to date copy of the Yorkshire and Humber Regional Escalation process and are familiar with how to use it.
c
The Trust has reviewed and agreed plans with partners to include the ambulance services that minimises the need for any diversion of patients between hospital sites and hospitals as part of their bed management arrangements.
Plans have been made implemented to increase and improve care pathways between partner organisations. Hours have also been increased at the Walk In Centre.
d
The Trust has agreed plans in place to escalate and manage the handover of care from the Ambulance Service to the A&E and all other hospital departments minimizing the risk of delayed Ambulance turnaround (as per the Ambulance contract).
There has been considerable work undertaken around turnaround this year with YAS, ensuring the handover is smoother and more efficient. This would be escalated as required.
6
Infection Control
a
The Trust has reviewed its local infection control outbreak management arrangements with the local Health Protection Unit/Public Health teams.
The PCT follows the HPA outbreak plan. Arrangements have been discussed and re viewed via the South Yorkshire Joint Partnership Board.
b
For PCTS only to complete
The commissioning arm of the PCT has established a strategic infection prevention and control committee, with representation from providers of health and social
The PCT working with local public health teams has ensured infection control arrangements in the independent sector by working with local authorities and 5
Winter Preparedness (All Trusts)
Trust Assurance Comment
local authority/NHS commissioners to ensure up to date infection control plans (to include staff training programmes) are in place.
care within Rotherham – outbreak reports are a standing agenda item of this committee. As commissioners we work closely with the HPU, Neighbourhood Services (Environmental Health) and the Local Authority.
7
Communications and Media Management
a
The Trust has reviewed its Winter Communications strategy to include how the Trust working with partners will ‘warn and inform ‘patients, staff and the public of disruptive events to service provision e.g. infection control outbreaks and reduced visiting.
The Trust is currently reviewing its winter communications strategy and is working with partners in the foundation trust and local authority to ensure work is coordinated and comprehensive across the borough.
b
The trust has tested on call systems in and out of hours to include checking local switchboards have up to date rotas and mobile phone coverage for staff on call.
On call numbers for all staff on the on-call rota have been confirmed. It has also been confirmed that there are no problems with mobile phone coverage for staff on-call should they be contacted at home. The switchboard at RFT receives and acts upon up to date rotas.
c
The Trust has reviewed its Communication on call systems, all staff have been updated on the role for On Call and have the knowledge, skills and facilities to cascade information out of hours
The trust does not operate a communications on call system. However the director on call does have access to contact details for communications personnel in the event of a media or communications incident.
