The University Hospitals Coventry and Warwickshire NHS Trust is a major trauma centre that deals with some of the most serious incidents in the country. In the latest of a series of blogs on winter, the Trust’s Emergency Planning Manager reveals how hospitals prepare for the inevitable seasonal pressures:
When most people think of winter and the NHS, they think “struggle”.
Most conjure up the image of vast numbers of patients with endless hospital waits and images suggesting there aren’t enough resources to cope. But you shouldn’t believe everything you read or see.
The reality is that a great deal of preparation takes place, months in advance, to prevent the so called “struggle”, and everyone works tirelessly to ensure patients get safe care.
Winter Plans are primarily aimed at three key areas: preparedness, prevention and protection against the major avoidable ill-effects of winter on people’s health.
Our Trust sees more than 175,000 patients every year, and a huge number of these will obviously visit us through the winter. My role along with my peers involves ensuring that every single one of these patients, their friends, families, as well as our staff, are safe when they’re with us.
In the lead up, and throughout the winter, some of the threats I prepare for include extreme weather, as well as IT, electrical, water and gas failures. There are other preparations and plans which I also work up. They apply to emergency services and responses to major incidents, which could invariably include mass casualties and danger to the public.
Most people are unaware of this element of winter planning.
We all know the NHS is continually under pressure, the media reports on it constantly. It’s exacerbated during winter when hospitals see a surge in demand and increased challenges with A&E often bearing the brunt of it.
This pressure isn’t solely due to the number of patients coming through A&E doors. What we see now is an increasing number of patients with complex needs which require more medical attention, and longer stays in hospitals.
This is a major issue we have had to adapt to. If we can’t discharge a patient because it’s not safe to return home, due to bad weather or lack of care or both, we then need to rethink and re-plan for how we’ll care for new patients coming through the door needing a bed.
Bad winter weather, such as snow and ice, or prolonged sub-zero temperatures inevitably increases demand. A sudden drop in temperature increases the risk of accidents and can increase the severity of injuries. It can also aggravate existing medical conditions, such as arthritis and respiratory issues, meaning people are more likely to need to come to hospital, adding to demand.
We consider all this and plan for it, and that planning, surprisingly, starts at the end of summer.
During winter the weather forecast is my best friend. I get direct alerts from the Met office which I continually communicate to senior colleagues. The frequent updates allow me to understand and plan for staff getting to work as well as for them returning home, and ensuring essential supply routes also keep moving.
The alert thresholds developed by the Met office are important triggers. They’re so useful that I’ve mirrored these triggers and matched them against what we do as an organisation. For example, if ice and or snow is predicted our estates department ensures our onsite roads and footpaths are gritted and free from ice so the hospital site can continue to run safely with minimal impact on patients and staff.
It’s a difficult balancing game to meet winter demands. We’re able to estimate the demands we are likely to face and prepare accordingly, but our plans need to be flexible. They need to respond to constantly changing demands and we have to manage that with resources availability.
We’re adept at it because hospitals and other health care organisations have a duty to ensure the delivery of high quality care throughout the winter period, no matter what it throws at us.
Planning for this seasonal event involves developing and implementing plans and corresponding local campaigns. This allows patients and the public to understand where to go and what do for minor and major ailments. It also ensures the system is informed of plans during winter; that staff and various departments know ‘the drill’ when responding to and dealing winter each year. Our ‘Winter Plan’ combines effective leadership, essential planning, an understanding of potential weaknesses and how to respond to any event.
What is most important, despite increasing demands, is that the NHS will not compromise patient care, or standards. We continually strive to learn from previous winters, identify potential risks we could face and options we can put in place to prevent them.
It’s a tough and fulfilling role and one I thoroughly enjoy.