03.03.15
Trusts told to ensure no repeat of New Year A&E problems at Easter
NHS trusts have been told to have “robust” resilience plans in place to cope with potential increases in patient demand over the Easter bank holiday.
In a letter sent to NHS CCG accountable officers, trust and foundation trust CEOs and heads of local government, it says that over recent months there has been a decline in the delivery against the four hour A&E standard.
Monitor, NHS England and the NHS Trust Development Authority said: “We expect every effort to be made to return to this standard in April.”
Officials were told that as part of the planning process, systems should review, and “explicitly address” in their plans any local issues and risks that were experienced during Christmas and New Year 2014-15.
“Plans should illustrate how those same risks will be mitigated at Easter, including those actions that have been taken to address any potential gaps.”
They added that for the Easter bank holiday, which falls in early April, the national tripartite organisations, working with the Association of Directors of Adult Social Services, would like to “reinforce the importance” of all organisations producing “robust demand and capacity plans”.
Specific areas they want to see tackled include routine GP surgery capacity on the Saturday morning on the bank holiday weekend; sufficient capacity provided in GP out-of-hours services; and NHS 111 staffing capacity increases to cope with potential surges in demand.
There are also calls for sufficient capacity across primary care, including pharmacy and dentistry, appropriate coverage for mental health services, and ensuring the continuation of discharge processes through local health and care economies.
In support of service delivery over Easter and throughout April, trusts are also “expected” to join in ‘National Breaking the Cycle’ initiatives running from 1 April to 15 April.
These initiatives will support delivery of urgent care services over the Easter period and into April, with the ambition of improving patient safety and experience and reducing the number of breaches of the A&E four-hour standard over that period.
At the heart of the initiative is the core structure of the ‘National Breaking the Cycle’ exercise and the SAFER patient flow bundle (Senior review, All patients to have an expected discharge date, Flow of patients to commence early, Early discharge, Review weekly in long length of stay cases).
The signatories of the letter added that “we do expect every trust” and their local partners in the wider system to ensure that they are taking actions, over the fortnight, to ensure emergency departments are well staffed with an extended senior medical and nursing presence supported by social care, community and mental health services.
Acute hospitals are being encouraged to implement the SAFER patient flow bundle and out-of-hours GPs and ambulance services must have easy access to appropriate senior clinicians to advise on the appropriateness of admissions and proposed conveyance to hospital.
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