1. Preparing for Winter 2010/11 Guidance Overview Stuart Low Planning Manager SG Health Delivery Directorate

2. 2009/10 NHSScotland Winter Review Good Performance over 2009/10. Good Performance over 2009/10. Considered NHSScotland Performance from a whole systems perspective. Considered NHSScotland Performance from a whole systems perspective. 2008/09 recommendations were well implemented. 2008/09 recommendations were well implemented. Expect NHS Boards to implement these recommendations during 2010/11. Expect NHS Boards to implement these recommendations during 2010/11.

3. Key Areas for Improvement 1. Reducing levels of boarding. 2. Increasing effectiveness of escalation planning. 3. Improving patient discharge levels over 4 day festive public holidays. 4. Improving management of norovirus outbreaks.

4. Reducing Levels of Boarding Boarding of Patients from the front door should be avoided. Boarding of Patients from the front door should be avoided. The majority of NHS Boards continue to board patients. The majority of NHS Boards continue to board patients. EADT/HDD commissioned project. EADT/HDD commissioned project. SGHD will continue to collect real time boarding data this winter. SGHD will continue to collect real time boarding data this winter. NHS Board senior managers expected to use this data as a key quality indicator. NHS Board senior managers expected to use this data as a key quality indicator.

5. Increasing the Effectiveness of Escalation Planning Critical in ensuring that services and performance are maintained. Critical in ensuring that services and performance are maintained. Plan should have clear escalation procedures. Plan should have clear escalation procedures. Escalation procedures should be linked to a sustainable resourcing plan. Escalation procedures should be linked to a sustainable resourcing plan. Make full use of community hospital beds. Make full use of community hospital beds.

6. Improving Patient Discharge Levels Working with COSLA to strengthen partnership working. Working with COSLA to strengthen partnership working. Ensure adequate care packages meet predicted discharge levels. Ensure adequate care packages meet predicted discharge levels. Identification of patient’s at high risk of admission will be important. Identification of patient’s at high risk of admission will be important. Ensure processes in place to maintain effective discharge levels (Especially over Festive Holidays) Ensure processes in place to maintain effective discharge levels (Especially over Festive Holidays)

7. Improving Management of Norovirus Outbreaks All Boards should follow Norovirus Outbreak Control Measures (HPS) All Boards should follow Norovirus Outbreak Control Measures (HPS) Be aware of national and local norovirus situation Be aware of national and local norovirus situation Emergency Medical Receiving Units should work closely with ICT’s. Emergency Medical Receiving Units should work closely with ICT’s. Be prepared for rapidly changing norovirus situations. Be prepared for rapidly changing norovirus situations.

8. Communications NHS 24 leading on 2010/11 winter media campaign. NHS 24 leading on 2010/11 winter media campaign. NHS Boards should issue local press releases to advise on local situation NHS Boards should issue local press releases to advise on local situation Ready Scotland provides a range of information on preparing for, and protecting against, emergency situations. Ready Scotland provides a range of information on preparing for, and protecting against, emergency situations. Ready Scotland Ready Scotland

9. Integration of Key Partners Demand, capacity and activity plans need to be fully integrated. Demand, capacity and activity plans need to be fully integrated. Collaboration between key partners is vital to ensure a whole systems approach. Collaboration between key partners is vital to ensure a whole systems approach. Provide assurance that winter plans are robust, well resourced and system-wide. Provide assurance that winter plans are robust, well resourced and system-wide.

10. Seasonal Flu Annual Seasonal Flu Vaccination for over 65s consistently exceeds CMO Target of 70%. Annual Seasonal Flu Vaccination for over 65s consistently exceeds CMO Target of 70%. Uptake of vaccination by NHS Staff remains low. Uptake of vaccination by NHS Staff remains low. Encourage vaccination for staff working with high risk patients (A+E, ITU, HDU). Encourage vaccination for staff working with high risk patients (A+E, ITU, HDU). Prepare for predicted surge in flu activity (October – March) Prepare for predicted surge in flu activity (October – March) Routinely monitor HPS updates. Routinely monitor HPS updates.

11. System Watch & Exception Reporting Ensure timely provision of admissions data to System Watch. Ensure timely provision of admissions data to System Watch. Provide immediate notification of significant service pressures. Provide immediate notification of significant service pressures. Winter reporting arrangements will be confirmed mid-October. Winter reporting arrangements will be confirmed mid-October. 4 Hours A&E remains a HEAT standard. 4 Hours A&E remains a HEAT standard. Decisions on suspending elective treatment will be made in discussion with Health Delivery Directorate. Decisions on suspending elective treatment will be made in discussion with Health Delivery Directorate.

12. NHS Board Resilience HDD sharing geographic information on emergency admissions due to falls & fractures. HDD sharing geographic information on emergency admissions due to falls & fractures. Facilitate discussions with LAs around local contingency planning. Facilitate discussions with LAs around local contingency planning. Ensure arrangements in place to manage short- term demands on mortuary facilities, especially over the winter holiday period. Ensure arrangements in place to manage short- term demands on mortuary facilities, especially over the winter holiday period. Ensure that due consideration is given to business continuity risks, particularly where services to community / vulnerable groups might be affected. Ensure that due consideration is given to business continuity risks, particularly where services to community / vulnerable groups might be affected.

13. Signing off Winter Plans NHS Boards expected to implement the 2008/09 recommendations NHS Boards expected to implement the 2008/09 recommendations No requirement to submit winter plans to SGHD No requirement to submit winter plans to SGHD Chief Execs should discuss at October Board meeting Chief Execs should discuss at October Board meeting Personally sign-off and publish plans. Personally sign-off and publish plans. Proposed Sign Off date - 29 October 2010 Proposed Sign Off date - 29 October 2010

14. Contacts & Further Guidance Key contacts listed for: Key contacts listed for: Winter planning Winter planning EADT EADT NHS 24, SAS, OOH Planning NHS 24, SAS, OOH Planning Performance Mangers (East / West) Performance Mangers (East / West) Further guidance provided: Further guidance provided: Winter Review Reports Winter Review Reports Norovirus Norovirus Influenza Influenza Patient Discharge Patient Discharge Scottish Road Network Scottish Road Network Ready Scotland Ready Scotland

15. Guidance Development Feedback invited from: Feedback invited from: Emergency Access Delivery Team (6 Sept). Emergency Access Delivery Team (6 Sept). SGHD policy areas (7 – 15 Sept). SGHD policy areas (7 – 15 Sept). RWP Events (21/23 Sept). RWP Events (21/23 Sept). NHS Board CEO’s / WP Leads etc. NHS Board CEO’s / WP Leads etc. Issue Final Guidance 30 Sept. Issue Final Guidance 30 Sept.