Moray Winter Plan 2016/17 15 - Winter Plan … · 2016/17 . 2 Introduction Each year the Health and...

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Appendix 1

Moray Winter Plan

2016/17

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Introduction Each year the Health and Social in Moray, including the Acute Sector in Dr Gray’s Hospital is subject to fluctuating pressures in the movement of patients into and out of hospital. Increasing pressure tends to be over the festive period and into January when there is more pressure to admit people into hospital or to manage people within their own homes. The key to successful Winter Planning is to ensure that wherever possible we pre-empt season specific challenges as well as having a robust Unscheduled Care Plan reflecting the recommended 6 essential actions. This includes ensuring flow through additional surge capacity within the Acute Sector and by collaboration with our Moray IJB colleagues to ensure continuity of Social Care access.

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MORAY UNSCHEDULED CARE WORK PLAN

6 Essential Actions to Improving Unscheduled Care Programme – 20016/17

1 Clinically

Focused and Empowered Hospital Management

Continued development of the local team to confirm recognised sustainable roles within the local team for:

clinical leadership

service improvement

health intelligence

programme management

Maintain senior management level leadership and ownership of patient flow by daily senior management attendance at safety and flow huddles, with a focus on supporting and embedding site wide and speciality escalation policies and improving communication Undertake a review of and further test Dr Gray’s Hospital site wide escalation policies, ensuring they encompass the wider healthcare system and focusing upon their effectiveness and outcomes, by Sept 2016.

Add clarity to required actions (action cards)

Disseminate escalation plans widely with clear expectations of actions

Establish leadership of escalation polices

Agree date for test

Debrief & Share feedback

Update policy

Communicate across the wider healthcare system

Share 6 Essential Actions work plans for Dr Gray’s site on Unscheduled Care Website. Continue to focus our attention on improving the flow of patients through the Community Hospital infrastructure through locality discussion and focused attention on key areas within the patient journey between hospitals and from hospital to home.

Medical superintendents meetings

Patient transfer group meetings

Community hospital improvement plan

2 Hospital

Capacity and

Patient Flow

Realignment

Use of the ‘Basic Building Block’ approach to: Prepare, as relevant for different staff groups, hourly, daily, weekly and monthly

performance data. Regular production and dissemination of scorecard showing the agreed metrics

Quarterly update ‘map of flow’

Dr Gray’s Hospital Operational Support Team to routinely oversee the daily admissions across the site utilising up to date live information (Wardview) on transfers and discharges with reference to the Basic Building Block Model.

Share weekly Utilisation report with Senior Charge Nurses

Community hospital manager to oversee daily activity and flow including admissions and discharges across the 5 Moray Community Hospitals. Undertake regular reviews of the Safety Brief & Flow huddles, Community Hospital Sitrep, Breach Analysis and the Cross Sector huddles, to continuously improve this approach to maintaining Hospital Flow and 4 hour performance.

Recent review undertaken

Repeat before winter – Lead Matthew Jobson Quality Improvement facilitator

Established improvement plan for community hospital sitrep

Process proposed test of change or joint funded (NHSG/SAS) F/T Hospital Ambulance Liaison Officer role located within Operational Support to improve cross service

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communication and system information in conjunction with highlighting impending USC activity and reducing SAS turnaround times Explore influences that result in SAS transporting uninjured patients who have fallen to hospital and link findings to ongoing work on USC Integrated Pathways for Frailty and Falls hosted in the Moray IJB.

3 Patient rather

than Bed

Management -

Operational

Performance

Maximise the potential to efficiently track patients’ journeys, using Wardview in Dr Gray’s, and focus on quality discharges through ongoing review of the processes and pathways that support patient flow.

Improve Patient focus and pathway management by hosting 3 improvement/networking events for key staff involved in managing patient pathways. Aim : Identify things that can make a difference, build cross sector & cross discipline relationships, demonstrate leadership by working together, create a sense for individuals of being valued, engender a focus around the patient being at the centre of our actions. Continue the improvement work within the patient transfer meeting:

Provision of a community hospital sitrep

Cross system examination of the community hospital waiting list

Test the establishment of multi disciplinary goal setting within acute stroke ward

Agree the required level of information required for patient transfer between hospital sites

Maintain and further implement across DGH and where appropriate community hospitals, the interventions that support the discharge of patients on or as close to the date that they are clinically fit for discharge

EDD,

Criteria Led Discharge,

Discharge focused Board Rounds,

Enhanced Recovery

AHP Goal Setting

Disseminate discharge policy

Review processes that support the smooth flow of patients from the hospital front door, with a specific focus on:

Psychiatric services

Paediatric services

Medical and Surgical Services.

Embed OT support in ED

OOH transfers from ED to Community Hospitals

Rehab interventions

Clinical support for Police custody suite

Further develop the Flow hub model at Dr Gray’s Hospital:

Develop thinking about: - the function of a Flow Hub/ who pulls all the strands of Flow management together? What are the escalation routes? Which roles form the flow hub?

Develop a role outline for Flow Hub development & management

Engage social care colleagues in co-ordination of flow on a daily basis – co-locate in Flow Hub

Develop Flow co-ordinators role in ED

Focus on reducing rates of boarding

Establish process for measuring boarding

Review current boarding policy

Improve rate of appropriate morning discharges

Review process for recording time of discharge and accuracy of data collected

Ensure process supports accurate and appropriate recording of discharge times

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Smooth discharge across weekends and public holidays

Collect activity data

Increase weekend discharges to community hospitals

Agree criteria for acceptance of a patient into a community hospital. Criteria Presented to medical superintendants group. Next meeting in Sept to look at handover communication and consolidate handover prior to trialling. Data and info on weekend transfers being collated.

Increase weekend discharges requiring social care support.

Agree improvement plan

Eliminate breaches during the challenging out of hours period

Extend pathfinder model of extended operational hours of the Operational Support service .

Undertake self assessment of Acute Quality Standards

4 Medical and

Surgical Clinical

Processes

arranged for

optimal care

Consistent application of agreed medical and surgical acute care arrangements to provide sufficient access to:

clinical assessment,

diagnostics

clinical interventions & rehabilitation

transfer without delay

Safe & efficient discharge.

NHS G/ SAS Transfer Policy

Review processes that support the smooth flow of patients from the hospital front door, with a specific focus on:

Access to Psychiatric services

Assessment by Paediatric services

Assessment by Medical and Surgical Services.

Rehabilitation interventions

OT support to ED

ED to Community Hospital transfers

Further expansion of Ambulatory Care Services at Dr Gray’s Hospital to include CDU and Surgical Assessment units

Identify funding source for physical alterations - endowments

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7 day services –

to smooth

variation across

“out of hours”

and weekend

working

Assess how variation can be eliminated from pathways over a 7 day period, with a particular focus on:

Diagnostics,

AHP,

Pharmacy

Social Work,

Community Hospital,

District nursing

transport pathway including Critical Care Transfer model that reduces nursing resource requirements

scope out potential for trialling weekend/twilight shifts of above services - identify funding if required

Establish links with the Point of Care Testing Project (Aberdeenshire Community hospitals) to ensure ability to position the project elsewhere in future

6 Ensuring

Patients are

cared for in their

own homes

Continue to work in partnership with IJBs to ensure Delayed Discharge Plans can be delivered and further improve discharge processes and pathways between the acute and community settings.

Communicate EDISON report cross system.

Liaise with IJBs delayed Discharge Group to establish a clear process around delayed discharges

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Examine appropriateness of Guardianship process in acute setting

Disseminate Discharge Process and deliver info sessions

Funding for continuation of 7 day AHP community based service. Further develop the Dr Gray’s Clinical Decision Support service ensuring it complies with the objectives of the organisational model for clinical decision support and meets the needs of both users and providers and to the benefit of patients. Emphasise KWTT message at all patient education opportunities through: Use of KWTT materials across NHSG sites Maintenance of website Additional Patient information boards and TV screens in ED waiting room & dept – Identify funding

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Acute Sector Dr Grays Hospital Surge Plan

Physical Bed Capacity Additional bed spaces are defined as physical areas which have bed head services. These should be included regardless of the wards ability to staff these spaces.

Ward Commissioned Beds Commissioned Trolleys

Additional Bed Spaces

Mon - Fri Sat- Sun Mon – Fri Sat – Sun With beds

With trolleys

Without bed or trolley

Day

Night

Day Night Day Night Day Night

7a 16 16 16 16 0 0 0 0 0 0 0

7b 16 16 16 16 0 0 0 0 0 0 0

8 (HDU) 8 8 8 8 0 0 0 0 0 0 0 AMAU 3 3 3 3 4 4 4 4 0 0 0 STROKE 8 8 8 8 0 0 0 0 0 0 0 CDU 5 5 5 5 0 0 0 0 0 0 0 5 30 30 30 30 0 0 0 0 0 0 0 6 30 30 30 30 0 0 0 0 0 0 0 DCU 0 0 0 0 19 19 19 19 4 0 0 SAU 4 4 4 4 3 3 3 3 0 0 0

Staffing Numbers Nursing

Ward Registered staff Rostered

Unregistered Staff Rostered

Total Head Count

Mon - Fri Sat- Sun Mon – Fri Sat – Sun

Registered Unregistered

Day Night Day Night Day Night Day Night

7a 3 2 3 2 2 1 2 1 14 11 7b 2 2 2 2 2 1 2 1 13 10 8 (HDU) 5 5 5 5 1 0 1 0

29 3

AMAU 2 2 2 2 1 0 1 0 14 4 STROKE 2 2 2 2 1 1 1 1 15 7 ED 5 3 5 3 0 0 0 0 31 0 CDU 1 1 1 1 1 0 1 0 5 5 3 5 3 3 1 3 1 22 10 6 5 3 5 3 3 1 3 1 22 10 DCU 5 0 0 0 1 0 0 0 17 2

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DCU closes at 2000. 1600 – 1900: 3 reg + 1 unreg. 1900 – 2000: 3 reg

SAU 2 2 2 2 1 0 0 0 8 1

Theatre 16 3 4 3 11 1 1 1 44 21

Theatre night duty: 1 reg on call

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Medical Staff- The number below is the maximum available. This number is reduced daily due to annual leave and study leave.

Speciality On Call On Site On Site Total Head Count

Consultants Middle Grades Juniors FY2 Consultants

Middle Grades Juniors Mon - Fri Sat- Sun Mon – Fri Sat – Sun Mon-Fri Sat-Sun

Day Night Day Night Day Night Day Night Day Night Day Night

Medicine 4 1 1 1 2 1 1 1 2 1 1 1 9 6 General Surgery

4 1 1 1 2 0.5 0.5 0.5 2 0.5 0.5 0.5 5 4 2

Orthopaedics 4 1 1 1 2 0.5 0.5 0.5 1 0.5 0.5 0.5 5 5 2 Anaesthetics 8 2 2 2 0 0 0 0 0 0 0 0 9 0 0

ED 1 1 1 1 1 1 1 1 1 1 1 1 1

* Each 0.5 reflects equal share of 1 WTE in cross cover arrangement working across general surgery and orthopaedics.

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Staff Contact Details Nursing staff contact list for calling in staff

Ward Named person responsible for keeping up to date

Location of list

DCU / SAU / PAU SSN Michelle Simmons Ward / Shared drive V

Ward 5/ PAU SCN Tracey Kramer-Taylor Ward / Shared Drive V

Ward 6 SCN Helen Bruce Ward / Shared Drive V

Ward 7a ASCN Sara-Jane Laing Ward / Shared Drive V

Ward 7b ASCN Sara-Jane Laing Ward / Shared Drive V

HDU SCN Julie McKenzie Ward / Shared Drive V

AMAU SCN Diane Vass Ward / Shared Drive V

Stroke SCN Diane Vass Ward / Shared Drive V

ED SCN Helen Mellis Ward / Shared Drive V

CDU SCN Helen Mellis Ward / Shared Drive V

Theatres SCN Karen Hughes Ward / Shared Drive V

Medical staff contact list for calling in staff

Speciality Named person responsible for keeping up to date

Location of list

Medicine Dr David Williams Barbara Cookson / Shared drive

General Surgery Mr Robert McIntyre Lynne Green / Shared drive

Orthopaedics Mr Colin Smart Susan Copeland / Shared drive

ED Dr Pamela Hardy Brenda Morgan / Shared drive

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To translate an escalating series of alerts that reflects an increase in emergency pressures that impact deteriorating patient flow requiring additional management and / or clinical action to mitigate the risk.

The alert status overview and definitions are:

STATUS WHAT DOES THIS MEAN WHAT ARE OUR IMMEDIATE ACTIONS

Level 1

LOW

RISK

GREEN

Cubicles & 2 Resuscitation bays available for use in ED

Less than 1 hour wait to be seen by assessing clinician – Majors or Minors

AMAU / SAU have capacity to meet demand

Agreed staffing levels in place across ED and inpatient wards

Medical / Surgical / Orthopaedic / HDU capacity meets demand

No beds or wards closed

All elective patients allocated beds

Ambulance handovers < 10mins with 4hr target being maintained

No external influences present – infectious diseases, adverse weather etc.

Defined as “NORMAL” levels of activity.

Communication of internal capacity pressures is on a periodic basis, notably in the form of a site report following the morning Hospital Safety Huddle meeting and in routine supplementary reports. Representatives from all areas to attend the Hospital Safety Huddle @ 9am (Mon-Fri) & 1030am (Sat–Sun)

Communicate with all outside agencies (including Social Work, SAS & PTS)

& community hospitals as per normal practice to prioritise & maintain flow.

Ensure all patients have a plan in place and any patients suitable / ready for transfer / discharge are transferred / discharged in a timely manner

Level 2

MEDIUM

RISK

AMBER

IT IS NOT INTENDED THAT AMBER STATUS SHOULD RESULT IN ANY ACTION LIKELY TO BE DISRUPTIVE TO NORMAL PATTERNS

OF ACTIVITY.

DECLARE AMBER (LEVEL 2) IF ANY OF THE CRITERIA BELOW MET:

ED majors reach 3 patients or 1 patient in Resuscitation bays with no plans to move patients out within 1 hour

4 patients in AMAU with more than 3 expected or 5 patients in SAU with more than 2 expected

Suboptimal staffing across ED and inpatient wards affecting patient flow

Problems with ANY Support Services impacting on patient care

Surgical / Medicine / Orthopaedic are predicting deficit in predicted figure for the day – but plans are in place to create capacity

Amber status represents “BUSY” but within normal boundaries.

REPEAT ACTIONS TAKEN IN LEVEL 1 (as above) WITH SPECIFIC ATTENTION TO INDIVIDUAL AREAS OF PRESSURE.

If applicable or Amber status is sustained Operational Support staff / SNP / SCN to liaise with the Site / on call Manager. Appropriate key staff to be informed of change in status e.g. specialty consultants of pressure areas.

Use the Cross Sector Huddle / liaise with colleagues at ARI to identify any escalation required in movement of patients across sectors

DR GRAY’S SITE ESCALATION PLAN

Dr Gray’s Alert Escalation Level

Level 1

Low Risk

Level 2

Medium

Risk

Level 3

High Risk

Level 4

Very High

Risk Risk

Ensuring our patients safety

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HDU are predicting less than 1 bed – but plans are in place to create capacity

Ambulance transfers > 20mins.

Bed closures due to infection control measures

Elective patients allocated beds but not available until later in the day

4hr target being maintained but breaches have occurred

Level 3

HIGH

RISK

RED

DECLARE RED (LEVEL 3) IF: Actions taken in level 2 have failed to mitigate the situation & further action requried OR There is likely to be disruption to normal patterns of activity

OR

If any of the criteria below met:

SAU / AMAU - Cannot accommodate emergency patients with no available option/plan to create capacity within 2 hours

HDU – No capacity, with no available option to create a bed within 2 hours

ED majors reaches 5 patients + 1 patient in Resuscitation bay with no capacity expected within the next 2 hours

Multiple areas below agreed staffing levels, patient safety becoming compromised

Significant problems with ANY Support Services impacting on patient care

Surgical / Orthopaedics areas full with no plans to create capacity without cancelling elective activity

Medical areas full with no identifiable ‘Boarders’

Ward closures due to infection control measure

ED staffing under pressure due to numbers within the department

Ambulance transfers > 30 mins

Red status represents “SIGNIFICANT RISK TO SAFETY” within an individual area or across the system. – repeat actions in level 1 & 2 as applicable

Operational support staff / SNP / SCN to liaise with the Site / on call Manager when status changes from Amber to Red to ensure appropriate key staff including on call specialty consultant(s) are aware of our status.

Site manager, senior social worker, discharge co-ordinator along with on call specialty consultant(s) & SCN(s) of pressurised area(s) may require to meet for an AREA SPECIFIC HUDDLE in order to plan out any further actions required to relieve pressure and maintain flow (during normal working hours) – Out of hours SCN / SNP / Operational support may need to initiate a similar meeting with the relevant on call consultants / SCN(s)

Duty/Site manager to consider redistribution of resources across sector or asking staff on non clinical duties to assist where necessary / appropriate

Operational support to liaise with ARI / Raigmore bed management teams Elective cancellation policy to be used as required

Level 4

VERY

HIGH

RISK

BLACK

DECLARE BLACK IF:

All escalation actions for Red escalation status implemented but have not been effective in mitigating the position OR If ALL of the criteria below are met

All room capacity inclusing resus bays are used within ED and there are additional patient occupied trolleys in use in the ED corridor

There are no assessment beds / trolleys free to see patients within AMAU / SAU / ED

Demand exceeds capacity for a sustained period with no evidence of patients moving on

Change in status will be triggered by the Site Manager who will urgently call a meeting with the following key personnel - all actions above should have been worked through prior to this status being declared

Site / Duty Manager / A&E Consultant / SCN

Operational Support Team Leader / Primary Care Representaion

Senior Social Work Representation / SAS

Following this meeting a formalised plan will be required that all personnel are in agreement with .

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ED are unable to take ambulance transfers

Average admissions The Acute Sector defines a surge as higher number of admissions then can be accommodated within available capacity. The number of patients that this refers to will vary depending on a number of circumstances.

Ward Average number of admissions on the busiest day of your week currently

Average percentage of these admissions that are elective

Which day is your busiest

5 / SAU 3 emergency & 3

elective (6) 50% Monday

6 2 emergency & 2

electives (4) 50% Weekend

7 4 emergency & 0


8 2 emergency & 1

elective (3) 33% Sunday

SW 1 emergency & 0


AMAU 3 emergency & 0


CDU 3 emergency & 0


Action Plans for Surge What actions would you at a speciality and then divisional level take to accommodate a surge

in activity as defined above.

Speciality / Ward Specific

Ward / Speciality

Responsible Person

Surgery Open 4 beds day case Duty Manager

Divisional

Action Responsible Person

Whole System Response: Planned and Emergency huddles to reduce admissions and facilitate early discharge including maximising use of Community Hospitals and use of spot purchased Nursing Home Beds.

DGM/ Duty manager

Last resort negotiate transfer of patients to ARI or Raigmore

DGM/ Duty manager

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Ward or Service (e.g. dietetics)

Areas closing/Activity ceasing over public holidays/change in use of area (Nil indicates no change to normal service)

A&E Nil

AMAU

Nil

General Medicine Ward 7

Nil

CDU

Nil

HDU

Nil

Surgical Ward 5 Nil

Orthopaedic Ward 6

Nil

Stroke

Nil

Outpatients Clinics will run as usual with the exception of the Public Holidays.

Theatre Main Theatre Suites will provide full teams of emergency staff as is usual practice 24/7. Extra bookable urgent sessions will identified over the festive period if deemed required by service management. All other elective sessions will be closed 26/27 Dec and 2 /3 Jan. SSU Theatres are closed 26/27 Dec and 2 /3 Jan. Ward 202 closed 25/26 Dec and 2 /3 Jan. Wood-end closed 26/27 Dec and 2 /3 Jan

Physiotherapy Normal working except for weekends and PHs when there will be on call cover 24/7 and rotas in orthopaedics (trauma and elective), respiratory and assessment in GAU.

Occupational Therapy Normal working unless stated below: Cover Sat 24th Dec 9am -1pm – Bleep 57652 No service Sun 25th & Mon 26th Dec Cover Tues 27th Dec 9am – 1pm – Bleep 57652 Cover Sat 31st Dec 9am – 1pm – Bleep 56752 No service Sun 1st Jan Cover Mon 2nd Jan & Tues 3rd Jan 9am – 1pm – Bleep 57652

SLT Normal working except for weekends. There will be a limited service available on PHs

Dietetics

Normal working except for weekends and PHs (when there will be no cover) Reduced staff 28, 29 & 30th Dec and 4th, 5 and 6th Jan. Ext for ward referrals to dietetics service: 63067.

FESTIVE ACTIVITY

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Elective activity varies dependant on the day of the week with a larger number of cases being brought in at the start of the week. Information has been shared with all Divisions which indicates their day before procedure admission rates, LoS and admission day profile. Units and individual Services are using their predictions to proactively manage demand.

Over the Festive period 2016/17 the Public Holidays fall on a Monday and a Tuesday for Christmas and New Year. All Radiology modalities prioritise their work over this period and when there is a larger than normal number of public holidays. The following modalities: CT, Ultrasound and MRI in Radiology plan to prioritise patients as follows:

Wed 21st Dec – Friday 23rd Dec & Wed 28th Dec – Friday 30th Dec both CT 1 and CT 2 will be kept for IP and Urgent OP (Biopsy, Cancer Staging etc) 22nd, 23rd, 28th 29th 30th Dec IP and Urgent OP only

Pharmacy 24th Dec – 26th Dec, and 31st Dec - 2nd Jan : closed. Contact Pharmacist on call through switchboard. 27th Dec and 3rd Jan: reduced staff, limited service

Undertake detailed analysis and planning to efficiently schedule elective activity (both short and medium term) based on forecast emergency and elective demand, to optimise whole systems business continuity. This should specifically take into account the surge in activity in the first week of January.

Radiology Plan for Festive period 2016/17

CT

US

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As jointly agreed with the Theatre management team, it is expected that elective surgical activity will continue through the winter period including the weeks immediately following the festive period (w/c 26/12, 02/01, 09/01, and 16/01). Operating lists during this time will be booked with priority given to, in order; cancer cases, urgent patients, and day case procedures observing TTG as best as possible. Where capacity allows other routine cases will be booked accordingly. Individual service teams will ensure that the above priorities are adhered to and will also consider the requirements for Ward and HDU beds when booking patients. These measures are designed to ensure that the surgical specialties have taken consideration of the anticipated increase in unscheduled admissions and should ensure that the requirement for any late/last-minute cancellations is minimised. In circumstances where cancellations are required it is expected that the decisions made follow the Standard Operating Procedure for the postponement of elective activity. This states that the site manager, general manager and on-call medical director are initially made aware as well as discussions with the clinical and operational teams of the services in question. It is essential that, at the very least, the relevant UOM, Clinical Director and Clinical Lead are aware of any potential cancellations. Contact details for these people can be found in the online directory or through switchboard/secretaries.

Daily Safety Brief Meetings - Managing our demand and flow

NHSG recognises that to optimise the number of times we achieve right patient, right place, right time we need to maximise our flow and improve effective discharge planning. To enable wards to do this more information than ever previously provided is available in the form of:

5 day in advance unscheduled and elective projection reports by ward

A daily report that updates on a live basis

Admission day before procedure rates

Discharge before 12 o’clock numbers

Boarder report

Standard Operating Procedure Postponement Of Elective Work

http://nhsgintranet.grampian.scot.nhs.uk/depts/AcuteSector/Winter/Documents/SOP%20-%20Postponement%20of%20Elective%20Activity%20Sept%202015%20ARI%20%20RACH.pdf

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The daily safety brief is delivered at 0900am and distributed across the Dr Grays Hospital and Moray IJB with identified actions and key personnel responsible to ensure actions are addressed/escalated or completed.

Moray Health & Social Care Partnership

Community Hospitals Physical Bed Capacity Additional bed spaces are defined as physical areas which have bed head services. These

should be included regardless of the wards ability to staff these spaces.

Ward Current Bed Capacity

Additional Bed Spaces

24/7 With beds

With trolleys

Without bed or trolley Total Available

Aberlour 10 10 1 1 2

Dufftown 18 18 0 1 2

Leanchoil 9 9 0 0 0

Seafield 24 24 0 0 2

Turner 19 19 0 2 4

Average admissions Community Hospital

Average number of admissions on the busiest day of your week currently

Average percentage of these admissions that are elective

Which day is your busiest

Fleming 4 admissions & 1 electives

25% Friday

Leanchoil 1 admissions & no electives

0% Monday & Tuesday

Seafield 7 admissions & 3 electives

55% Wednesday

Stephen 3 admissions & no electives

0% Thursday

Turner 3 admissions & no electives

0% Friday

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Staffing Numbers Nursing

Ward Registered staff Rostered

Unregistered Staff Rostered

Total Head Count

Mon - Fri Sat- Sun Mon – Fri Sat – Sun

Registered Unregistered

Day Night Day Night Day Night Day Night

Aberlour 2 1 2 1 2 1 2 1 4 3

Dufftown 3 2 2 2 3 1 1 1 5 3

Leanchoil 2 1 2 1 2 1 2 1 4 3

Seafield 3 2 3 2 4 2 4 2 5 6

Turner 3 2 2 2 3 1 3 1 5 4

Staff Contact Details Community Hospital Manager: Fiona Abbott ([email protected]) 07817958788 Nursing staff contact list for calling in staff

Ward Named person responsible for keeping

up to date

Location of list

Aberlour SCN Keith MacKay Ward / Shared drive V

Dufftown SCN Keith MacKay Ward / Shared Drive V

Leanchoil SCN Gillian Walker Ward / Shared Drive V

Seafield SCN Jim Brown Ward / Shared Drive V

Turner SCN Anita Kreft Ward / Shared Drive V

mailto:[email protected]

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Complementary Community Bed Provision

1. Step Up Beds

There are two step up beds in Elgin for the use of Elgin and Lossiemouth patients only. This is designed to support the fact that there is no community hospital in Elgin. Due to care home registration purposes the beds must be managed by the District Nurses in Elgin and Lossiemouth. Only the District Nurses can admit patients to these beds.

2. Jubilee Cottages

The Jubilee Cottages will provide short term (up to 6 weeks) specific high intensity rehabilitation to service users who are not requiring ongoing medical treatment, through the use of specific activities in order to help individuals reach their maximum level of function and independence in all aspects of daily living. The rehabilitation service will be provided free of charge by the Community Care Department, entering into an agreement with the Trustees to take over the use of 6 vacant cottages in a quiet and well located area of central Elgin. All individuals attending Victoria Cottages will be eligible for the service either from a community hospital, an acute hospital (inclusive of ward 4) or directly from their own home. They will be assessed on a one to one basis trying to match the potential user rehabilitation’s needs with the space limitations of the cottages; therefore, the clients will require to have capacity and motivation to improve their functional status in order to reach their previous level of independence or further improve it. The cottages will be equipped with a telecare service to provide a 24 hour on call response. The existing services of GMeds and DN’s will also provide cover to the cottages. The specific rehabilitation aimed at the Jubilee Cottages differs from standard rehabilitation in the way that the service is provided in a low risk, controlled home environment through high intensity and collaborative rehabilitation to foster an encouraged independence to return home in a maximum of 6 weeks.

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3. Hanover (Scotland) Housing Development, Forres

Primary care delivered in homes and residential settings, where the individual patient controls access and ‘owns’ the premises. It is usually one-to-one, equipment brought in as it is needed and it is less visible, less protected and less predictable. The psychological contract with the patient is entirely different and has been shown to be highly beneficial. District nurses will lead on this model. They are expert practitioners of the wholly different skills required to nurse people in their homes or in residential settings. The District Nurses will lead the transition to the use of new technologies within the home, including increasingly complex but portable medical and monitoring equipment. This new model will not only provide ‘close to home nursing care’ when the patients home is not an option. It also aims to develop a flexible and adaptable service that will work alongside other health and social care staff to develop support plans that suit the needs of individuals rather than services. Out of hours nursing interventions will be delivered as a collective by the nurses in Forres and this will meet the desired outcomes of individuals. As isolated functions this had not been possible but as a collective, working with different partners e.g. home carers, new relationships will be established and a whole new way of working across Forres will emerge. Working in partnership with Forres Health Centre and Hanover (Scotland) Housing Association Ltd, the rationale for this pilot is to use 5 of the 33 units within this development as Augumented Care Units (ACU’s).

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WORKFORCE

Action Outcomes Measure Deadline Lead Offer staff the opportunity to access the seasonal flu vaccine, and have protected time to attend their vaccination appointment

To minimise the risk of spreading flu to patients, colleagues and members of the public

The % of staff who are vaccinated

April 2017 Service Manager

Ensure that there is sufficient bank capacity for Moray.

We will have sufficient staff available at all times particularly in event of pandemic or similar event.

Bank costs On-going Anne McKenzie

All bank staff to be suitably trained through the induction programme within a month of being employed

We will have sufficient staff available at all times to ensure safe quality care for patients

% of bank staff who

have undertaken

their induction

On-going Anne McKenzie

Sickness absence to be managed using NHS Grampian/Moray Council and local protocols

Protocols are adhered to consistently % compliance with

referrals to OHS

On-going Service Manager

Ensure that workforce capacity plans and staff rotas are agreed

Patients receive the right intervention at the right time without any unnecessary delays

Annual leave policies

are implemented

On-going Service Manager

Ensure all staff are aware of the procedures for obtaining & organising home oxygen services

To enable patients to receive timely referral from home oxygen service

1st Dec 2016

Lesley Attridge

Remind all staff regarding the moving on & discharge policies

The finalisation of the hospital discharge policy – which includes / pays reference to the moving on policy

Staff awareness End Dec 2016

Lesley Attridge

Completion of critical functions, continuity plans business continuity in response to challenges

Each Community Hospital will have a surge plan covering current bed capacity, space for expansion , OOH contact lists, definition of surge & contingency plans

End of Dec 2016

Anne McKenzie

To minimise the spread of Norovirus outbreaks

Teams are effectively prepared to manage single & multiple outbreaks

Training Session(s) 1 Dec 2016 Anne McKenzie

Remind all staff regarding the Attendance at Work adverse conditions policy

Teams are effectively prepared to manage Staff awareness On-going Service Manager

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District Nursing including Pitgaveny and OOH

Staff Contact Details Team Manager for District Nursing Moray: Carol MacDonald ([email protected]) Mobile 07557317800

District Nursing Moray included Pitgaveny and OOH Marie Curie

Month December January

Location 19 20 21 22 23 24 25 PH PH 28 29 30 31 1 PH PH 4 5 6 7 8

Fochabers and Keith 6 7 6 7 6 1 1 2 3 7 7 6 1 1 2 3 7 7 7 1 1

Speyside 3 3 3 3 3 1 1 1 1 4 4 4 1 1 4 4 4 3 3 1 1

Buckie 7 7 7 6 7 1 1 2 3 6 6 6 1 1 1 1

Lossiemouth 5 5 5 5 5 1 1 1 1 2 5 5 1 1 2 2 5 5 5 1 1

Maryhill 6 6 6 6 7 1 1 1 1 6 6 6 1 1 2 2 6 7 7 1 1

Linkwood 5 5 5 4 5 1 1 1 2 5 5 5 1 1 1 2 5 4 5 1 1

Elgin Community Surgery 3 3 3 2 3 1 1 1 2 3 3 3 1 1 1 3 3 2 3 1 1

Forres 5 5 5 5 5 1 1 5 5 5 5 5 1 1 1 2 5 5 5 1 1

Total of community nurses 40 41 40 38 41 8 8 14 18 38 41 40 8 8 13 18 35 33 35 8 8

Pitgaveny Nurses 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4

OOH Marie curie 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

Total of staff on duty in 24 hours 46 47 46 44 47 14 14 20 24 44 47 46 14 14 19 24 41 39 41 14 14

mailto:[email protected]

23

Community Hospital Occupational Therapy

Community Hospitals

Moray

26th Dec Public

Holiday

27th Dec Public

Holiday

28th Dec 29th Dec 30th Dec 2nd Jan Public

Holiday

3rd Jan Public

Holiday

4th Jan 5th Jan 6th Jan

Seafield Hospital No Service No Service Normal service OT+OTSW

Normal Service OTSW + satellite support from DGH OT/Community OT


No Service

No Service

Normal Service OT +OTSW

Normal Service OTSW + physio + satellite support from DGH OT/Community OT


Turner Memorial Hospital

No Service No Service Normal service OT + OTSW



No Service

No Service

Normal Service OT +OTSW



Leanchoil/Stephen/Fleming Hospitals

No Service No Service OTSW + physio + satellite support from DGH OT/Community OT

OTSW + physio + satellite support from DGH OT/Community OT

OTSW + physio + satellite support from DGH OT/Community OT

No Service

No Service

Normal Service OT + OTSW



Glassgreen Therapy Team

No Service No Service Normal Service OTSW + physio

Normal service OT + OTSW

Normal Service OTSW + physio

No Service

No Service

Normal service OTSW + physio


Normal Service OTSW + physio

Further service No Service No Service OT's will be based with the Access team and will be working jointly to provide a duty OT service

No Service

No Service

Normal Service

Normal Service Normal Service

24

Community Hospitals Physiotherapy

Community Hospitals Moray

26th Dec Public

Holiday

27th Dec Public

Holiday

28th Dec 29th Dec 30th Dec 2nd Jan Public

Holiday

3rd Jan Public

Holiday

4th Jan 5th Jan 6th Jan

Seafield Hospital No Service No Service

Satellite Qualified PT support from Community/DGH

team

PT/OT SW

Satellite Qualified PT

support from Community/DG

H team PT/OT SW

Qualified Physio Cover

PT/OT SW

No Service

No Service


available

PT/OT SW


available

PT/OT SW


available

PT/OT SW

Turner Memorial Hospital

No Service No Service


team

PT/OT SW



H team PT/OT SW


PT/OT SW

No Service

No Service


available

PT/OT SW


available

PT/OT SW


available

PT/OT SW

Leanchoil No Service No Service


team

PTSW

Normal Service

PTSW

Normal Service

PTSW

No Service

No Service



H team PTSW

Normal Service

PTSW

Normal Service

PTSW

Stephen/Fleming Hospitals



team

Qualified Physio cover

PT/OTSW


support from Community/DGH

team PT/OTSW

No Service

No Service



H team PT/OTSW


PT/OTSW



H team PT/OTSW

Glassgreen Therapy Team



team

PT/OT SW


PT/OT SW


support from Community/DGH

team PT/OT SW

No Service

No Service

Normal service

PT/OT SW

Normal Service

PT/OT SW

Normal Service

PT/OT SW

25

X-Ray Department

week beginning 19th December 2016 AM- Monday, Wednesday, Friday at Forres AM-Tuesday, Friday at Keith PM- Friday at Dufftown AM- Monday, Tuesday and Thursday at Buckie week beginning 26th December 2016 NB: no provision Monday or Tuesday - limited the rest of the week AM- Wednesday and Friday at Forres AM - Thursday at Keith PM - Thursday at Dufftown AM - Thursday at Buckie week beginning 2nd January 2017 NB: provision Monday or Tuesday - limited the rest of the week AM- Wednesday, Friday at Forres AM- Friday at Keith PM- Friday at Dufftown AM- Thursday at Buckie week beginning 9th January 2017 Normal service from Monday 9th January.

Ward or Service (e.g. dietetics)

Areas closing/Activity ceasing over public holidays/change in use of area (Nil indicates no change to normal service)

SLT Adult team dysphagia: week beginning 26th December 2016 no provision Monday or Tuesday - limited cover 28,29 &30th December week beginning 2nd January 2017 no provision Monday or Tuesday - limited cover 4th, 5th,6th January Paediatric dysphagia will have to be referred to RACH team. NB: A telephone only service will run for community paediatrics over this period week beginning 9th January 2017 Normal service from Monday 9th January.

Dietetics week beginning 26th December 2016 no provision Monday or Tuesday - limited cover 28,29 &30th December week beginning 2nd January 2017 no provision Monday or Tuesday - limited cover 4th, 5th,6th January

Podiatry week beginning 26th December 2016 no provision Monday or Tuesday - limited the rest of the week week beginning 2nd January 2017 no provision Monday or Tuesday - limited the rest of the week NB: if a patient has a problem in a location where the clinic is closed they can be offered an appointment at another clinic as close to their local area as possible week beginning 9th January 2017 Normal service from Monday 9th January.

26

Pharmacy

Grampian Community Pharmacy Holiday Cover.xlsx

Moray Mental Health Service

Date Hours

26th and 27th December 2016

Closed

28th, 29th and 30th December 2016

Limited Service

31st December 2016 to 3rd January 2017

Closed

4th January 2017

Normal service resumes

NB: Ward 4 is open as normal throughout the festive period

27

MORAY HEALTH & SOCIAL CARE PARTNERSHIP

MANAGEMENT OFFICES

Date Hours

26th and 27th December 2016 Closed

28th, 29th and 30th December 2016 Limited

31st December 2016 to 3rd January 2017 Closed

4th January 2017

Normal service

MORAY COUNCIL

Community Care Access Team

Date Hours

25th to 27th December 2016 Closed

28th & 29th December 2016 Working

30th December 2016 Limited

31st December 2016 to 3rd January 2017

Closed

4th January 2017 All offices open

All residential establishments and homecare services will operate as

usual during the holiday period. During Office hours, the limited service provided on the days above will be available at the following

establishments

Out of Hours Emergency contact number: 0345 7565656

28

JOINT EQUIPMENT STORE

Date Hours

25th to 27th December 2016 Closed

28th & 29th December 2016 Limited Service

30th December 2016 to 3rd January 2017

Closed

4th January 2017 Normal service resumes

There is OOHS stock in the Blue secure container on the Pinefield site

whilst the store is closed. The stock contains both OT and Nursing equipment. District and Pitgaveny Nurses both have the access codes

to this container.

OT equipment can also be access OOHS stock that is held on site at Dr Grays.

Additional Contact details

ARI Social Work Dept

0845 456 6000/ 01224553510

ACC Home Care and Sheltered Housing

01224 814814

Out of Hours Service

From 4:00pm 24th Dec – 8:30am 5th Jan 01224 693936

29

Appendices

Page Appendix Number and Topic

1 COTAG escalation - to activate COTAG 2 COTAG Activation Form 3 SAS 4 NHS G Pharmacy Opening Times 5 Contact details for Senior Managers 6 Algorithm for the transfer of patients from ED out

of hours/weekends/public holidays 7 Dr Grays SOP Postponement of Elective work

http://nhsgintranet.grampian.scot.nhs.uk/depts/AcuteSector/Winter/Documents/COTAG%20Form.pdf

30

In situations of extreme and exceptional circumstances e.g. severe winter weather, 4 x 4 capabilities are available via COTAG 1. NHS Grampian will only activate COTAG when all interventions to ensure business continuity have been tried and failed or are likely to fail. Any activation must be in accordance with the Memorandum of Understanding between NHS Grampian and COTAG 4x4 Response Ltd. 2. COTAG does not provide an emergency service therefore any response is dependent on availability and conditions. COTAG, as a voluntary organisation will require sufficient time to assess the situation, prepare and respond. 3. COTAG is activated via ARI Switchboard on 0845 456 6000 once appropriate authorisation has been obtained. Switchboard will contact the COTAG on behalf of the caller and thereafter the COTAG Duty Operations Controller (DOC) or Operations Team Leader (OTL) will establish and maintain communications with NHSG member of staff. The DOC/OTL will discuss the detail of the activation with the member of staff requesting assistance from COTAG. 4. Staff must ensure that they have obtained appropriate authorisation before contacting switchboard. The activation of COTAG must be authorised by: -

In Hours: Sector General Manager or deputy. or

·Out of hours: the Site Manager 5. The person requesting the activation must ensure they have all of the necessary details about the assistance required and contact telephone numbers COTAG may need. This is essential information required by the COTAG Duty Operations Controller (DOC).

Appendix 1 - COTAG Escalation - TO ACTIVATE COTAG

31

Please complete a separate form for ach COTAG Activation. Please ensue it is signed and a copy sent to: Civil Contingency Unit Summerfield House 2 Eday Road Aberdeen AB15 6RE

Name of Person requesting COTAG Assistance:

Sector:

Authorised by (name):

Date:

Time activated:

Time stood down (if appropriate)

Brief outline of assistance required:

Additional Comments

Civil Contingencies Unit aware: Yes/No

Signature:

Appendix 2 - COTAG Activation Form

http://nhsgintranet.grampian.scot.nhs.uk/depts/AcuteSector/Winter/Documents/COTAG%20Form.pdf

32

4x4 Vehicles, Winter Tyres (WT) or Snow Chains (SC) Callout of 4x4 vehicles initiated

by ACC when required, through staff mobile numbers.

PRU 4X4 VEHICLES AEU 4x4

VEHICLES PTS 4x4 VEHICLES OPERATIONAL

SUPPORT 4x4

VEHICLES

1 x CRV Buckie.

1 x Huntly 1 x Tomintoul 1 x Dufftown 1 x Elgin

1 x CRV Elgin.

Staff cars 2 x Octavia 4x4 Karen Birse, ASM Drew Carr, Ops Support Mgr

British Red Cross British Red Cross SORT

4x4 availability 2 x Inverness Ambulances

2 x Land Rovers based at Dalcross Airport 1 x Nissan Patrol – Elgin

1 x VW Transporter 4x4 2 x Land rover Defenders 1 x Ambulance A&E 4x4

Appendix 3 - SAS

33

ARI-Dispensary ARI- Distribution ARI Technical (Aseptic)

Dr Gray’s Hospital

Contact numbers

Tel 53182 Fax 53383

Tel 53227 Fax 54422

Tel 53369

Tel 67366

Prescriptions and One-stop dispensing

Routine and One-off orders

Prescriptions and non-routine orders

19.12.16 – 23.12.16

08.30-18.00 Normal Service


08.00 – 16.30 Normal service

08.45 – 12.45 13.30 – 17.00 Normal service

24.12.16

09.00-13.00 Enhanced Weekend Service

09.00-13.00 Weekend Service

No service

CLOSED

25.12.16

10.00-14.00 Urgent prescriptions, orders and enquiries

CLOSED

CLOSED

CLOSED

26.12.16

08.30-17.00 Reduced staff - limited service


CLOSED

CLOSED

27.12.16



08.00 – 1630 Normal service

08.45 – 12.45 13.30 – 17.00 Reduced staff - limited service

28.12.16 – 30.12.16




08.45 – 12.45 13.30 – 17.00 Normal service

31.12.16

09.00-13.00 Enhanced Weekend Service

09.00-13.00 Weekend Service

No service

CLOSED

1.1.17

10.00-14.00 Urgent prescriptions, orders and enquiries

CLOSED

CLOSED

CLOSED

2.1.17



CLOSED

CLOSED

3.1.17




08.45 – 12.45 13.30 – 17.00 Reduced staff - limited service

4.1.17 – 6.1.17




08.45 – 12.45 13.30 – 17.00 Normal service

Appendix 4 - NHS G Pharmacy Opening Times

Manager Title Contact Details PA Contact Details

Jane Mackie

Joint Operational Manager 01343 567127 07875034203 [email protected]

Julie Laing 01343 567122 [email protected]

Lesley Attridge

Service Manager OT & Int care 01343 567130 07800678514 [email protected]

JoAnne Robertson

01343 567103 [email protected]

Alison Smart Assessment/Care/Community Nursing Service Manager

01343 567112 0785576762 [email protected]

Rachel Foster 01343 567132 [email protected]

Joyce Lorimer Social Work Service Manager 01343 567131 077779999258 [email protected]


John Campbell

Provider Services Manager 01343 567139 07527387515 [email protected]

JoAnne Robertson


Roddy Huggan

Commissioning & Performance Manager 01343 567132 07854686091 [email protected]


George McLean

Business Manager 01343 567128 07775954103 [email protected]

Nicola Staunton

01343.567137 [email protected]

Sean Coady Head of Primary Care, Prevention and Child Health

01343 567129 07766782956 [email protected]

Nicola Staunton


Anne McKenzie

AHP Lead & Service Manager 01343 567156 07876258866 [email protected]

Yvonne Watson

01343 567113 (67113) [email protected]

Jennie Williams

Service Manager Children & Young 01343 567113 07876258845 [email protected]

Yvonne Watson

01343 567113 (67113) [email protected]

Appendix 5 - Moray Senior Manager Contact Details

Tracey Gervaise

Health &Wellbeing Lead 01343 567133 07815593287 [email protected]

Lisa Davies 01343 567119 [email protected]

Sandy Dustan Dr. Gray’s Hospital Manager 07880 788010 01343 567287 01464 820579 [email protected]

Alison McGregor


Karen Thomson

Unit Operational Manager Unscheduled and Medical Services

01343 567841 07557 849040 [email protected]

Alison McGregor


Chris Macdonald

Unit Operational Manager Surgical Services

01343 567595 07557317798 [email protected]

Alison McGregor


Linda Oldroyd Lead Nurse 01343 567900 07876258472 [email protected]

Alison McGregor


Brydie duPon Service manager Dr Grays 01343 567351 07842570696 [email protected]

Alison McGregor


Liz Tait Professional Lead for Clinical Governance 01343 567116 07876258468 [email protected]

Nicola Staunton


Alasdair Walker

Clinical Directorate Manager of Adult mental Health

07979770633 [email protected]

Vicky Lang 01343 567909 [email protected]

Linda Harper

Associate Director of Nursing (Practice Nursing)

01224 558426 07876258825 [email protected]

Yvonne Watson

01343 567113 (67113) [email protected]

mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]

Appendix 6 Algorithm for the Transfer of Patients from ED Out of Hours / Weekends / Public Holidays

Patient in ED and assessed as requiring admission to a

community hospital

Patient in ED and assessed as being fit to

go home with / without support

Patient in ED and assessed as

requiring admission to acute bed

All transfers to Community Hospitals to be completed prior to 2000 hours

Contact SNP / Op Support

SNP / Op Support will liaise with Community Hospital

Agreement to transfer: SNP / Op Support to liaise with DGH staff to

facilitate transfer as below

No Agreement to transfer: Alternative plan. Admit to DGH or other community hospital On call managers may be contacted for

advice / support

EMP to: assess on community hospital clerking in

sheet, including physical assessment – lungs

/ heart

Include a plan for the next 24 / 48 hours

Write hospital prescription

Nurse to: Photocopy paperwork

Attach completed prescription

sheet

Identify and source any unusual

drugs (not core stock) to

accompany patient

Provide a verbal handover

Book transport – contact taxi OOH

Patient Transfers to Community Hospital

Patient stable following transfer

If patient deteriorates following transfer. Contact GMED OOH, faxing a copy of the patient’s medical documentation and plan to GMED

Version: 1.1 Date: 4

th September 2015

Next Planned Review: September 2016

Revision History:

Version Date Summary of Changes Approved By

1.1 4th September Minor changes as via medical manager discussion Terminology change for DGH

M Toms

Contents

1. Procedure ......................................................................................................................

2. Areas of Responsibility ................................................................................................

3. SOP Instruction .............................................................................................................

4. Contact Details – Secretarial Services ........................................................................

5. Definitions/Abbreviations ............................................................................................

6. Appendix A - Guidance for Staff Contacting Patients ...............................................

Standard Operating Procedure Postponement of Elective Work

DGH

Appendix 7 - Dr Grays SOP Postponement of Elective work

Standard Operating Procedure for Postponement of Elective Activity

1. Procedure

As a result of sustained demand for hospital beds, a robust and efficient system for the identification and postponement of elective/planned admissions is required to enable patients with the most urgent clinical need to be admitted. The postponement of elective activity as a result of sustained demand on beds should only be considered following discussion with and the full agreement of the Senior On Call Manager for Dr Grays, the Site Manager, General Manager1 and the On-Call Medical Director. General principles around patient groups excluded (in priority order) are: Clinically urgent Cancer procedures Will breach any access target if postponed All elective admissions will be dependent upon bed capacity within the hospital and the ability to decant to other clinical areas appropriately. Where necessary, patients may be asked to remain at home whilst efforts are made to identify an available bed. Secretarial and Operational Support staff should use Appendix A as guidance when contacting patients.

The following will need to agree to the postponement of elective activity: Senior manager on call and Site Manager and On Call Medical Director and General Manager (if available) The following will be involved in the process:

Operational Support Team (DG)

Administration Services Manager (DGH) And any other member of staff involved in the postponement of elective activity

1 If available (i.e. in hours and GM is at work), if not discretion is delegated to the Site Manager

2. Areas of Responsibility

3. SOP Instruction

Bed pressure identified by Operational Support Team/Duty Manager

Elective admissions identified by Surgical Support Manager via BOXI report ‘PMS TCI Report v2.2’

Discussion takes place with Site Manager,

General Manager & On Call Medical Director

with decision made to postpone elective

admissions

Service & ward area informed of decision to postpone elective admissions: Within normal working hours: Duty Manager contacts Administration Services Manager Out with normal working hours: Duty Manager contacts Nurse in Charge for ward area & Operational Support Team

Medical Secretary should forward details of patients contacted and postponed to Surgical Support Manager. A full record of postponed patient details will be

kept by Surgical Support Manager on shared

drive.

Patient is contacted: Within normal working hours: Medical Secretary Out with normal working hours: Senior Charge Nurse / Duty Manager Where the secretary has been unable to contact the patient by end of the day, this should be passed to the Duty Manager.

Duty Manager informs Corporate Communications

4. Contact Details – Secretarial Services

Dr Grays Medical Secretarial Team Contact Details Administration Service Manager Lorna Stewart Ext 67049, [email protected] Medical Secretary Supervisor Lorna Watson Ext 67901, [email protected] Alternative Contacts Phyllis McHattie Ext 67264, [email protected] Moray Health & Social Care Partnership Medical Secretarial Team Contact Details Administration Service Manager Anita Farquhar, 01542 837031, [email protected]

5. Definitions/Abbreviations

Elective Admission - Planned Admission BOXI - Tool for producing details of elective admissions

6. Appendix A

Guidance for Staff Contacting Patients The following is intended as guidance for members of staff contacting patients

Risk of Postponement

‘….Dr Gray’s Hospital is currently experiencing extreme demand for beds as a result of emergency admissions. The hospital is working to alleviate this situation however would like to advise you that there is a risk of your admission being postponed. We will contact you as soon as your bed is available and assist you with any necessary arrangements. Your patience and understanding is appreciated during this extremely busy time’.

Admission is to be postponed

‘…Dr Gray’s Hospital is currently experiencing extreme demand for beds as a result of emergency admissions. The hospital has been working to alleviate this situation however regretfully it has been found necessary to postpone your admission. We apologise for this situation and thank you for your patience and understanding during this extremely busy time’. Wherever possible a new date for admission should be offered to the patient at the point of contact however where this is not possible, the patient should be advised that they will be contacted again in the near future to advise of a new date.

Moray Winter Plan 2016/17 15 - Winter Plan … · 2016/17 . 2 Introduction Each year the Health and...

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