1. Managing with Extreme Weather Ralph Roberts Chief Operating Officer

2. NHS Borders - Context Smallest mainland Health Board in Scotland 1 DGH 4 Community Hospitals 24 GP Practices Single LA New Chief Executive 2 new Executive Directors

3. Population – 110,000 1800 Square Miles 65% of the population live outside settlements of 10,000 people, (28% for Scotland)

5. Monday 4 th January Public Holiday Review of “Festive period” –A&E @ 99% –A&E activity down 9% –60 beds fewer across system –9% fewer admissions –Discharges / admissions in balance cold spell over festive period

6. Tuesday 5 th January Planned reduction in Elective Activity – URGENTS only New Executive Team meeting Schools closed – access SBC Emergency Co-ordination group – review forecast / school opening Extreme weather NOT forecast overnight

7. Wednesday 6 th Jan Heavy snowfall (15cm) freezing temps ( -14 c) Most B & C class roads impassable A Class roads – 4 WD only

8. Wednesday 6 th Jan: Early AM 06:30 – BGH Staffing issues escalated Emergency Services only / Public Communication Facilities for Night Staff 09:00 – HQ closed – Crisis Management Team at BGH

9. Wednesday 6 th Jan: AM Establish Crisis Management Team SBC Strategic Co-ordinating Group – “the bunker” Staffing / Service review by site Electives for 7 th January Information / Public Communication Late shift Staffing

10. Wednesday 6 th Jan: PM Supplies Information / Public Communication Emergency Retrieval Helicopter Out of Hours transport

11. Wednesday 6 th Jan: PM Supplies Information / Public Communication Emergency Retrieval Helicopter Out of Hours transport Night staff Initial Transport review Planning for 7 th Jan

12. Thursday 7 th Jan Limited additional snow Temp remain around -10 c Most B & C roads closed all day A class roads passable from mid afternoon

13. Thursday 7 th Jan Crisis Management Team Staffing – 2 shifts ahead Transport Hub Patient transport

14. Thursday 7 th Jan Crisis Management Team Staffing – 2 shifts ahead Transport Hub Patient transport Non emergency activity for Friday ? Emergency Retrieval

15. Thursday 7 th Jan Crisis Management Team Staffing – 2 shifts ahead Transport Hub Patient transport Non Emergency services for Friday ? Emergency Retrieval Crisis team / Operational teams

16. Friday 8 th Jan Elective services operating HQ re-opened Recovery phase

17. Friday 8 th Jan Elective services operating HQ re-opened Recovery phase Weekend Plans “counting the cost” Public Communications

18. Lessons - Systems Business Continuity Plans - initial escalation - scenarios - communication / Crisis Team -Information / IM&T -Decision Log

19. Lessons - Systems Business Continuity Plans - initial escalation - scenarios - communication / Crisis Team -Information / IM&T -Decision Log Transport - access to 4WD - supplies

20. Lessons - Systems Business Continuity Plans - initial escalation - scenarios - communication / Crisis Team -Information / IM&T -Decision Log Transport - access to 4WD - supplies Multi Agency links

21. Lessons - Systems Business Continuity Plans - initial escalation - scenarios - communication / Crisis Team -Information / IM&T -Decision Log Transport - access to 4WD - supplies Multi Agency links Specific patient groups - Vulnerable - Cancer - Dialysis - Emergency retrieval

22. Lessons - Staff Rate limiting factor Junior Doctors Contact Transport Flexibility Variability Policies / FAQs

23. Lessons - Communications Positive Control Simple messages Focus Staff

24. The big freeze grips the region True grit needed as big chill Grips the region Town is “cut off” as snow Wreaks havoc Winter White Out

25. Life - Savers Valiant efforts tackle Snowfall in Scottish Borders Snow hits stricken helicopter for six Borders snow clearance battle continues Keeping warm and well in the cold snap

26. Community spirit helped elderly survive Sea King returns to the skies Supplies on a sledge for hospital patients Exceptional efforts of NHS Borders Workers during the big freeze NHS Borders staff go the extra mile NHS Borders: Normal service resumes

27. Thank You Questions ?