1. TEES VALLEY HEALTH SCRUTINY WINTER PREPAREDNESS 19 December 2011

2. Winter 2011/12 How winter and winter pressures have been managed to date 1.Flu vaccinations 2.Daily sitreps and pressure being faced by services 3.Weekly conference calls 4.Preparations for Christmas

3. 1. Flu Vaccination Steps taken:  Region & Local Communication Plans  Flu fighter roadshows/Local GP champions  Targeted info to ‘at risk’ groups  Clinical Bulletins  Flu letters to relevant ‘at risk’ practitioners/professionals

4. Flu Vaccination Latest data – staff

5. Flu Vaccination Latest data – at risk groups: Over 65s – target 75 %, actual 71% Under 65 with underlying condition – target 60%, actual 47% Pregnant women – target 60%, actual 29% Letter to midwives

6. 2. Daily Sitreps and Pressures Being Faced by Services Since 2 November 2011, provided to commissioners and SHA daily by: Acute providers Community providers Out of Hours Local Authorities NEAS NHS Direct Mental Health

7. Daily Sitreps Details include: NEEP level Serious operational issues in last 24 hours and remedial actions A&E – closures, diverts, trolley waits Cancelled operations Ambulance queuing Beds available Beds closed due to D & V / norovirus Beds unavailable due to delayed transfers of care Critical care beds Media interest Staff levels

8. Daily Sitreps – key issues to date North Tees and Hartlepool: NEEP 1 12 December delayed discharges - 10 South Tees Hospitals: NEEP 1 / 2 12 December delayed discharges - 26 County Durham and Darlington: NEEP 2 / 3 12 December delayed discharges - 29

9. NEEP level 3 – Pressure triggers  Evidence of significantly increased activity across Tees. Activity is placing real pressure on organisations  Actions taken at NEEP level 2 have not reduced pressure on organisations  2 or more organisations in Tees reporting NEEP level 3  Deterioration in weather conditions, or severe weather forecast that threatens to cause widespread disruption  SHA identify need to regional command and control of NHS  Declared major incident affecting 1 NHS organisation on Tees Note NEEP level 1 (normal) and NEEP level 2 (concern) must have been worked through before arriving at NEEP level 3

10. 3. Commissioner/SHA Conference Calls Weekly – unless required more frequently, as of 14 December 2011, only 2 additional calls required so far 2 calls – Commissioner with providers at 11am, commissioners with SHA at 12 noon Daily when 1 or more NE organisations are at NEEP 3 Key issues for SHA so far: –Justification/challenge of NEEP level reported –Mutual aid requests and procedures –Bed availability/step down from CCU/HDU/ITU –Delayed discharges –Delayed handovers

11. 4. Preparations for Christmas and New Year 1.twitter, facebook, Hartlepool Mail, Evening Gazette, LA publications, general press releases, radio campaigns, television adverts Vaccinations Choose well/choose the right service Keep warm Order prescriptions in advance Opening times

12. 4. Preparations for Christmas and New Year 2.General press releases – ‘keep winter bugs out of hospital’, ‘don’t become another statistic this Christmas’, ‘don’t forget your winter prescriptions’ 3.PCSA arrangements for pharmacy and GP opening times 4.On-call arrangements 5.Arrangements for conference calls over Christmas/ New Year period