1. Winter Planning: key risks Sheena Macleod

2. Delayed Discharges Working with Highland and A&B Councils to reduce length of festive ‘shutdown’ Use of ACPAs, SPARRA & inpatient data, Extended Community & Primary Care Teams ACPAs available to admission wards/assessment units Board rounds with traffic lighted patients and ‘community pull’ Complex case discharge coordinator in Lochaber Change Fund – capacity building Rapid response, virtual ward and intermediate care available and being built further via Change Fund initiatives

3. Boarding Main risk area – Raigmore 2010/11 reduced LoS, reduced boarding 2011/12 Kaizen work undertaken, actions ongoing 3xbed state meetings per day normal practice

4. Escalation Robust and longstanding policy in place linked with business continuity arrangements Bed state management robust EDD is routine practice Transport booking arrangement in place with SAS – RGH Criteria led discharge 18RTT – mainstreamed activity

5. Communications On call systems in place 2010/11 complexity arising from daily reporting requirement – needs to add value Severe weather, difficult conditions is ‘what we do’ in Highland Business continuity systems in place year round - expect the unexpected! Partnerships - Red Cross, SAS, Coastguard, Police for 4x4 vehicle support for staff/patient transport Know who to turn to and get ready for winter campaigns in place