1. Winter Planning in Dumfries and Galloway

2. CHP involvement Dumfries and Galloway has single CHP covering acute, community and mental health settings Historically has an excellent reputation for working with partners Fully worked up and tested Flu Pandemic plan Fully worked up major incident plan Business Continuity Plans in place Currently revising escalation plan to involve all stakeholders

3. Predicting activity Nationally System Watch is proving unreliable as a predictive tool. Work on going between ISD and NHS Dumfries and Galloway to begin to understand the difficulties. Local information being utilised to predict admissions/ occupancy levels using historical data and ALOS. Planned admissions reviewed in light of predicted unscheduled care activity a week in advance.

4. Capacity Management – Acute Daily bed capacity meetings Front loading first week in January with day cases Extension of 23 hour approach – ward re-designated Centralised booking – ensures decisions to admit based upon clinical priority when capacity tight.

5. Capacity Management - community Ensure community hospital beds fully open over winter period STARS development as discharge service of choice linking with Care and Support Services and utilising joint pool of healthcare support workers this has recently been enhanced by the secondment of further staff Vulnerable Patient Initiative supported by OOHs will allow earlier discharge for identified patients

6. OOHs Working with NHS 24 to predict activity and inform staffing levels No salaried medical or support staff allocated annual leave during the main two week festive period In the event of severe snow and life- threatening emergencies local GPs would be asked to respond

7. Integrated working between OOHs & A&E department Co-location of the OOHs service and the A&E service allows for joint working Increasing co-operation between the 2 services Emergency and Unscheduled Care Nursing Service supported by OOHs transport Sessions for Galloway Community Hospital and Accident and Emergency Dept will be monitored with the Rural and Hospital Practitioners there considered as part of the wider “pooled” team

8. Community Pharmacy Pharmacists will be opening during the festive season – information shared with NHS 24 and advertised in the local press GPs will put reminder note on the right hand side of the prescriptions issued regarding avoiding running out of medication during festive period

9. Mental health Crisis Assessment and Treatment Service available over festive period Reduced level of CMHT available.

10. Staffing Staff Flu Vaccination Consultant presence for discharges throughout festive period Community Hospitals fully staffed throughout festive period

11. Transport 4x4 vehicles available within both main NHS and OOHs fleet Vehicles used to transport key staff into work Vehicles used to support patient discharge and transport in periods of severe bad weather from remote areas Vehicles used to support delivery of district nursing service Extra PTS discharge vehicle time purchased to support weekend discharges from acute services

13. Transport – joint working with Council NHS transport routes have been shared with Council and input into their electronic navigation system Bank of drivers within the council pool available to NHS should major staffing difficulties arise Electronic navigation system is portable and compatible with NHS vehicles

14. Roads and Gritting Agreement with Council Roads department that following gritting major routes access routes to hospital facilities will be considered a priority. Agreement with council to clear and grit NHS premises