1. Stirling Management Centre 11 th September 2014 Unscheduled Care National Event Learning Workshop

2. Festive Key Messages 2 x 4 day festive periods (25-28 Dec / 1-4 Jan) Respiratory & circulatory care Planned activity & capacity, including social care capacity Staff rotas over festive periods Senior clinical decision making capacity – Discharge Escalation / surge plans (Staffing) Seasonal flu – staff (50% min) / public vaccination Business continuity Staff / public communication plans

3. Priorities – Now & Winter 1.Emergency (Medical & Surgical) & elective capacity planning & management 2.Whole hospital realignment/re-booting strategy

4. DOWNSTREAMDOWNSTREAM SITE/SECTOR CAPACITY/FLOW BASIC BUILDING BLOCKS Number of self and 999 attendances Number of G.P. referrals. Clarify who makes and receives the calls? ED Assessment Unit(s) & What purpose? R E C E I V I N G Or what other design/ flow? Rehab Home Other Flows Discharge Lounge Boarding Number of Direct Admission planned/ unplanned Number of Cubicles Separate and dedicated minors flow Yes/No Open 24/7 ? Number of Staff per 100 attendances by grade Number of Beds Number of Beds/Cubicles Discharge/ Transfer Average numbers per day/annual to each destination Number of Staff per 100 attendances, by grade Number of Beds Hospital at Home Integration Plan LDP Delayed Discharg e

5. 3.Engage & empower local clinical & non-clinical teams 4.Professional & managerial leadership around: a.Pre-noon and weekend discharge rates b.Ward transfer processes

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7. 5.Recruitment & Retention strategy now for current, February & August gaps – act now (local, regional & national) 6.Delayed Discharge numbers yes, but also bed days lost to Delayed Discharge and patients awaiting care packages in the community.

8. GP in & OOH’s Services, Social Care, NHS 24, SAS, ED, GP Sub-specialisation 95% Target Hospital Assessment, treatment, & admission Joint anticipatory care, frailty models Site elective & Emergency Demand & Capacity Planning Internal Flow In Patient Discharge Planning Effective Integrated Chronic Disease and Discharge Management Alternatives to attendance and admission Digital health Appropriately Avoiding long term care. Rehabilitation Community Hospitals Care at Home Delivery of sustainable Unscheduled Care Performance: A Whole System Target

9. Sir Muir Gray’s presentation on community based specialty care.

10. Alternatives to Admission “Direct” admission Anticipatory Care Hospital at Home

11. Hospital Specialists Sector/Practice Teams (Sub Specialisation and Primary/Community Care Consultants?) Community Based Health Care Shared Goals and Teams

12. Key National Groups UC Steering Group Primary Care Strategic Forum 7 Day Task Force Vision New Teams Role Development Senior Decision Support Model Clinician/Team Match Condition/Presentation by time of day