1. Managing Key Risks Duncan Pollock Health Care Manager
Medical Specialties

2. Key Risks Fewer beds Possible ward closures – infection
Increased demand and peaks
Change fund progress

3. 1. Fewer beds Issues Fewer surgical beds Fewer medical beds
Dermatology redesign
Fewer rehab beds
Fewer continuing care beds
Less opportunity for medical boarding
Actions
ongoing LEAN has reduced medical LOS on 2 main sites by 0.4 & 0.3 days.
Short stay beds (<72 hrs) ring fenced
Priority ward rounds
Acute medicine clinics
Revised escalation
ZERO boarding aspiration

4. 2. Possible ward closures
Issues
Continued IC support
Flu isolation arrangements
Vaccination levels
D&V isolation and re-opening policies
Actions
IC commitment to patient flow meetings
Reinforce and relearn rules successfully applied in the past
Aim to > vaccination levels, particularly in key ‘winter’ areas (on ward with target)
Enhanced and targeted re-clean arrangements

5. 3. Increased demand and peaks
Issues
Attendances rising
Holiday periods
Sustained pressure
Higher acuity
Poor weather
Actions
Planned deployment of clinicians working in corporate departments (actively helping work up patients for discharge).
Controlled annual leave
Extra consultant ward rounds
Deploy additional domestic and portering support where required

6. 4. Change fund progress Issues Actions
Change Fund will support winter planning.
Reducing unplanned admissions and acute bed days in the over 75 population through effective, integrated community services and closer coordination of services between acute and community.
New tiered model of care will support a range of services from carer support and volunteering to specialist, integrated care in the community.
Actions
In the interim . . .
Increase ambulance services for more discharges
Extra community equipment for expanded out of hours care
Extra assessment and discharge from acute services
Extra targeted care home support
Prepare 12 surge beds in a designated area that can be opened as part of escalation policy