1. Unscheduled Care Winter Workshop 2013/14 Winter Analysis & Preparing for Winter 2014/15 Stirling Management Centre 11 Sept 2014

2. Unscheduled Care October to March Sources: ISD A&E datamart; ISD SMR01

3. A&E performance (%) & waits over 12 hours weekly, Nov to Mar Source: Weekly management information submitted to Scottish Government

4. A&E performance (%) Source: ISD A&E datamart

5. Delayed Discharges Delayed Discharges over 4 weeks (including Code 9) Bed Days Lost to Delayed Discharge

6. Norovirus Source: HPS

7. Flu – within normal threshold Source: HPS

8. Winter respiratory deaths

9. TTG – waits over 12 weeks (seen) Source: ISD Waiting Times Warehouse

10. Cancer 62 day standard (%) Source: ISD Cancer Waiting Times Warehouse

11. Increasing Workforce Change since last year Source: ISD

12. Preparing for Winter Guidance 2014/15 Winter planning supports delivery of LUCAPs DG H&SC / CEO NHS Scotland Letter to NHS Boards (19 Sept 2014) Self-Assessment Checklists (Annex)

13. Self-assessment checklists 1.Resilience 2.Unscheduled/Elective Care 3.Out of Hours 4.Norovirus 5.Seasonal Flu 6.Respiratory Pathway 7.Mgt Information 8.Sign-off 9.Integration of Key Partners / Services

14. Festive Key Messages 2 x 4 day festive periods (25-28 Dec / 1-4 Jan) Respiratory & circulatory care Planned activity & capacity, including social care capacity Staff rotas over festive periods Senior clinical decision making capacity – Discharge Escalation / surge plans (Staffing) Seasonal flu – staff (50% min) / public vaccination Business continuity Staff / public communication plans

15. Priorities – Now & Winter 1.Emergency (Medical & Surgical) & elective capacity planning & management 2.Whole hospital realignment/re-booting strategy

16. DOWNSTREAMDOWNSTREAM SITE/SECTOR CAPACITY/FLOW BASIC BUILDING BLOCKS Number of self and 999 attendances Number of G.P. referrals. Clarify who makes and receives the calls? ED Assessment Unit(s) & What purpose? R E C E I V I N G Or what other design/ flow? Rehab Home Other Flows Discharge Lounge Boarding Number of Direct Admission planned/ unplanned Number of Cubicles Separate and dedicated minors flow Yes/No Open 24/7 ? Number of Staff per 100 attendances by grade Number of Beds Number of Beds/Cubicles Discharge/ Transfer Average numbers per day/annual to each destination Number of Staff per 100 attendances, by grade Number of Beds Hospital at Home Integration Plan LDP Delayed Discharg e

17. 3.Engage & empower local clinical & non-clinical teams 4.Professional & managerial leadership around: a.Pre-noon and weekend discharge rates b.Ward transfer processes

18. 18

19. 5.Recruitment & Retention strategy now for current, February & August gaps – act now (local, regional & national) 6.Delayed Discharge numbers yes, but also bed days lost to Delayed Discharge and patients awaiting care packages in the community.