Winter
Useful documents, links and information
Winter grab guides
NHS England and NHS Improvement have developed in partnership with the Queen’s Nursing Institute (QNI) five key digital grab guides in recognition of the pressures and challenges that can continue to build in the system during the winter months. The guides include a checklist to help health and social care colleagues to take prompt practical actions and use every opportunity to prevent delayed transfers of care. Through using these guides, health and social care staff can address the evidence that staying in hospital for longer than required drives adverse outcomes for patients:
- Act now – maximise your leadership this winter
- Act now – plan for discharge early
- Act now – getting people Home First
- Act now – new technology to find care home availability
- Act now – look after yourself, look after others: flu immunisation
Operational Pressures Escalation Levels (OPEL) Framework and Action Cards
- OPEL Framework – HTV
- OPEL 2 Action Card
- OPEL 3 Action Card
- OPEL 4 Organisational Action Card
- OPEL 4 System Action Card
Onward Care
Training
Mental health
- Case studies – Mental health and A&E pressures
- Top tips for reducing mental health delayed transfers of care
- Blog post: Dr Rob Bale, clinical director and consultant psychiatrist, asks: ‘Have you got a winter mental health plan?’
- Winter planning for Mental Health Exercise & Scenario Report
Care homes
National winter letters
Seasonal flu letters
- Health care worker flu vaccination – 7 September 2018
- Extension of NHS seasonal influenza vaccination – 10 September 2018
National dashboards
Reports
- Understanding Resilient System A&E Performance – to help support and refine local plans
Escalation triggers based on Trust ED Performance
Acute Trusts will continue to report daily to NHS Improvement. The following have been identified as key measures that will trigger intervention from the Programme Management Office (PMO):
- An A&E 4 hour performance of less than 95%, but there will be a particular focus on trusts whose performance is below 85% for the previous day.
- Deterioration of A&E performance of more than 10% compared with the same day 6 week average,
- Ambulance delays where more than five have been delayed for more than 60 minutes.
- One or more 12 hour breach in A&E.
- An increase in beds closed due to D&V by 20 beds from one day to the next.
- In addition, any major patient safety incidents worthy of discussion at a national level will be highlighted.
Where performance has triggered one indicator | PMO to discuss with STP lead |
Where performance has triggered two indicators | Regional Director to contact STP lead |
Where performance has triggered three or more indicators | Regional Director to contact Trust CEO |
RBH Celebrating Patient Flow Workshop
- Welcome and scene setting – Mary Sherry
- West Berkshire System Wide Winter Resilience Plans December 2018-March 2019
- The role of NHS 111 in the patient flow pathway – Thames Valley Integrated Urgent Care
- Primary Medical Services Enhanced Access – 7 day working
- Rapid response falls service
- Emergency Department Organisation
- Clinical site team and on-call management
- Ward flow – board rounds, actions for patients every day and early bird discharges
- Battle Day Unit and the last day in hospital
- Community beds and transfer process
- Acute Medicine model
- SAU – Surgical Assessment Unit figures
- Urology hot clinic
- Patient Story – Patient Flow
- The Integrated Discharge Service
- Partnership working with local authorities
- Care Home Selection_CHS
- Discharge planning and Home First
Reducing long hospital stays – The #longstaywednesday approach