1. Unscheduled Care Learning event Escalation Workstream Michael Bloomfield/Debbie Burns 19 March 2015

2. Key Issues Regional Unscheduled Care Escalation Plan updated Trusts reviewed/revised local Escalation Plans Trust tests of local escalation plans Effectiveness of ED dashboard reviewed NIAS role to manage GP calls to ED

3. Escalation – What Worked Well? Commitment of staff Early, senior intervention Command/control co-ordination Senior manager presence at weekends/holidays HALOs

4. Escalation - challenges Sustained periods of escalation Accessing community care over holiday periods Securing additional staffing Cancellation of elective activity Repatriation of patients Cross-Trust discharges Patient/family choice Extent of 7-day services Access to real time information

5. Escalation - Learning Earlier identification of pressures/triggers Earlier confirmation of winter pressures funding Improve timeliness of information on bed status Communication with patients and families Early discharge planning