Ten Top Tips for Winter Planning

By Jim O'Connell, Transformation Consultant, Kingsgate

Every winter sees rising demand for healthcare services, and the NHS often struggles to cope. We’ve all heard about the cancelled operations and trolleys in hospital corridors.

Preparing well for this period is essential, if services are not be overrun. Here are my ten top tips for NHS winter planning.

1. Additional Beds

Even if Emergency Department visits reduce, people are likely to be sicker than at other times of year. This means longer stays in hospital and more pressure on beds.

Ideally, it’s worth opening a temporary Winter Ward that can be used to accommodate the additional demand.??

This can take many forms depending on the bottlenecks that are being tackled – maybe out in the community, or within the acute hospital as a ward for patients who can go home first.

If additional beds aren’t provided and non-medical beds have to be used, there’ll be a negative impact on patients.?Surgery will be cancelled, length of stay will increase and so will inappropriate care because the setting will be wrong.?Ward rounds to see scattered patients will take longer and it will be harder to find space for emergency patients who need to be admitted.

2. Discharge dates and ward rounds

Every patient should have an estimated date of discharge within 14 hours of admission. Daily ward rounds are standard good practice, with twice-daily rounds in assessment areas. During winter it’s even more important that this ‘drum beat’ is maintained.?Otherwise patients will be delayed at every stage their treatement journey, causing further bottlenecks.

3. Additional social care capacity – Assessment & Package of Care capacity

The extra pressure on beds in winter makes it even more important to address discharge bottlenecks. It’s essential that NHS organisations and social care partners work closely together to ensure that their work during winter is joined up.

In this way patients’ needs can be assessed quickly and the right social care packages put in place, so that they can leave hospital. If additional funding is available to the NHS, it might be better deployed in social care, so that the best possible patient flow can be achieved across the system.

4. Social care at the front door

During winter unnecessary hospital admissions can occur because there is nowhere else for the patient to go. A bed in an acute hospital can become the only available safe option. This can be avoided if the appropriate (sometimes at a quite junior Care Assistant level) social care support is available when patients arrive at hospital.

5. Physiotherapy at the front door

Some admissions can be avoided if the right therapy is given quickly enough. Having physiotherapists deployed can help with this, especially for older patients.?Ideally a Care of the Elderly Consultant should also be deployed at the front door, to ensure that elderly patients in general aren’t admitted unnecessarily.?

I’ll share tips 6-10 tomorrow!