1. Winter Pressures Emergency access Getting it right for patients and staff June 2009

2. So far…… Capacity and demand planning – Manpower Distribution Staff availability – Doctors, nurses, allied health professionals and social services The system is largely predictable – Daily - weekly - monthly – Elective and emergency not elective v emergency

3. The data said... Buffered – sustainableNo buffer – not sustainable Capacity

4. The data said...

5. ‘System Stress’ – Admission and Discharge Profile for all specialties

6. Impact of medical outliers (boarders) *Critical incidents

7. Later More on predictive tools Vulnerable groups – Elderly – Mental Health When does acute attendance = system failure

8. Now - Breakout groups – What are you going to do differently Capacity and demand planning Escalation – Planning has not worked – Exceptional variation(demand) Communication – does everyone know and can and will respond Approach – Multi-professional – Multi-organisational Relative test – What would you want for your mother/father/son/daughter

9. Do our systems meet our aspirations Why can’t I get timely information about my patients before they arrive ? If only I had the information I need to improve performance Can’t our systems support the way we work? Why is it so difficult to find out about my treatment? Why do I have to wait so long ?

10. ‘Here is Edward Bear, coming downstairs now, bump, bump, bump, on the back of his head, behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there really is another way, if only he could stop bumping for a moment and think of it.‘