As part of the Western Trust’s Winter Preparedness Planning, we are implementing a range of actions in the period ahead which are detailed under the headings below:
-
Maximising Ambulance Capacity
Work with Northern Ireland Ambulance Service to support timely ambulance handover at our Emergency Departments and smoother transfer of patients, eg Handover zones, Hospital Ambulance Liaison Officer support.
Provision of GP access to a range of specialties for advice and referral.
Pilot mental health staff presence in ambulance control room at weekends.
Fully operational Minor Injuries Unit at Altnagelvin providing rapid access for assessment and treatment of minor injuries.
Effective use of community services and pathways such as Hospital at Home, rapid response nursing services and district nursing to keep people well at home and support unnecessary Emergency Department attendance and admission avoidance where appropriate.
Continued engagement with care homes through our care home support team to provide training and support to avoid unnecessary hospital attendance.
Delivery of vaccination programmes for Covid-19, Flu, Pertussis, RSV and MMR for eligible groups.
-
Reducing Time Spent in ED
Continued access to timely specialty in-reach to review patients in the Emergency Department.
Maximise existing pathways and rapid access arrangements – minor injuries unit, acute medical model, paediatric pathway, early pregnancy, gynaecology pathways, ENT rapid access clinic, eye casualty.
Ensure best use of ambulatory and same day emergency care opportunities:
- Altnagelvin Hospital – enhanced Ambulatory Care Unit, the cardiology and respiratory hubs and paediatric assessment unit;
- Omagh Hospital – cardiac assessment unit, urgent care and treatment centre
- South West Acute Hospital – Same Day Emergency Care Unit, paediatric assessment area and a minors area within SWAH ED providing rapid access for assessment and treatment of minor injuries.
Co-ordination hubs and enhanced oversight arrangements in place to effectively manage patient flow and capacity in our hospitals and community.
Access to mental health expertise in our Emergency Departments to allow timely joint assessment by medical and mental health teams.
Continued implementation of agreed contingency plan arrangements to provide crisis support when patients are delayed awaiting admission to a mental health inpatient facility.
Agreed escalation processes in place to support a response to increased site pressures.
-
Timely Hospital Discharge
Engagement with and support for patient, carers and family to promote safe and timely discharge.
Co-ordinated approach to safe and appropriate patient discharge arrangements – creation of a discharge co-ordination team, making best use of the discharge lounge and continued implementation of the trusted assessor role to support timely allocation of care home placements.
Maximise our domiciliary care capacity through the continued roll-out of the Trust’s rota optimisation project and review of packages of care to ensure they remain suitable by the early review and assessment team and enhanced care panel.
Use of growth investment to increase community bed capacity through 4 additional palliative care beds in Omagh Hospital and 19 additional nursing home beds.
Creation of a homecare transition team to increase availability of homecare / reablement capacity in rural Fermanagh and reduce the number of patients delayed in hospital waiting for domiciliary care package.
Reconfiguration of residential beds to enhance intermediate care and EMI bed provision
Work collaboratively with other Trusts to ensure timely repatriation for all transfers of patients to their home Trusts.
-
Protecting Elective Care
Focus on delivering HSC Service Delivery Plan targets and associated recovery plans.
Ensure elective inpatient and day case theatre capacity is maximised across all our sites including promotion of dedicated elective care centre in Omagh and elective overnight stay centre in South West Acute Hospital.
Maximise in-year funding allocations to support waiting list initiatives to deliver additional assessments, diagnostic tests and treatments through a combination of in-house and in-sourced and outsourced independent sector capacity.
Maintain a focus on elective care delivery through the Elective Care Group oversight and monitoring arrangement to ensure capacity is optimised.
-
Key Enablers
Protecting and Promoting Staff Health and Wellbeing
Provide resources and programmes to support staff wellbeing including advice and support on nutrition and exercise, stress management, building resilience and mental health support.
Flu and Covid vaccination programme for staff.
Minimise vacancies by expediting recruitment where possible through Healthdaq, maintaining talent pools on Healthdaq for targeted staffing groups and proactively fill staffing gaps by addressing early projected staffing requirements with recruitment campaigns.
Leadership
Ongoing visible leadership, enhanced during increased service pressures.
Frequent staff engagement and communication at all levels.
Implement Trust surge plans and business continuity arrangements, as required.
Monitoring and Reporting
Enhanced oversight at all levels across the organisation.
Regional co-ordination, communication and co-operation.
Work as part of regional co-ordination centre to minimise disruption to patients.