
Northern Health and Social Care Trust Winter Plan 2024-25
Northern Trust Winter Plan 2024/2025 (PDF)
Introduction
This information is to help us share with the public, our plans for health and social care services over the winter months. Winter is always a challenging period for our Health and Social Care system, with demand for services typically increasing at this time of year. A busy winter period means increased pressures on primary care, our hospitals and community services.
As we prepare for another winter season, the Northern Trust has set out its annual Winter Preparedness Plan which outlines actions and measures being put in place to manage this anticipated increase in demand on our services, particularly around emergency care.
Regardless of the pressures on the health and social care system, we remain committed to providing the highest standards of care with our community, in our community. We hope you find this information helpful.
Context
We expect the winter months to be challenging given the continuing and sustained demand on services all year round.
Our staff are our greatest resource and we will continue to support them to stay healthy and well.
Health and Social Care relies on the commitment and resilience of our staff who deliver our services with compassion and care.
Across Health and Social Care throughout the region, three areas have been identified as key areas for focus to support people to stay well, remain at home and avoid hospital admission.
Maximising ambulance capacity
Reducing time spent by patients in Emergency Departments awaiting clinical decision and next stage of care
Timely hospital discharge for patients who are medically fit.
Our plan also identifies key enablers which will be crucial to our success, including our staff’s health and wellbeing, preparations for a surge in respiratory-related illness, and comprehensive local and regional oversight arrangements.
Delivery of Services
During the coming months, we may find it difficult to provide all of our planned services whilst also managing the expected increase in demand for unscheduled or critical care. Patient safety will always be our priority, whilst we balance these risks.
This Winter will also see a major healthcare transformation initiative with encompass set to ‘go-live’ within the Northern Trust. encompass is a digital initiative to replace the current paper healthcare record system. As we implement this new digital system there may be some disruption to our services. The is because our staff will be getting used to encompass and the significant changes it will bring.
We ask everyone to be patient as we implement this new way of working. The new system will improve patient safety and change the way health and social care is delivered in the future.
Patient Timely Discharge
Across our hospital sites, we anticipate an increase in demand for inpatient beds. Therefore, timely discharge of patients once medically fit, remains key to ensuring all patients can be admitted in a timely way.
It is our priority to ensure patients are discharged safely from hospital to the most appropriate place; however this may not always be to your preferred option. We ask for support and flexibility from families and carers with discharge planning arrangements to help us achieve a safe discharge and to ensure beds are available for other patients who require inpatient assessment and treatment.
Despite the best efforts outlined above, there will be times that patients have to stay in the ED whilst waiting for a bed to become available in a ward. Further surges of respiratory illnesses will impact on service delivery and bed availability.
Primary Care
The Health and Social Care system relies on the availability and sustainability of patient care outside of hospital and public confidence in other services. We will continue to work closely with Primary Care to promote direct access pathways where appropriate. Partnership working between the Trust and Primary Care services will ensure the smooth transition of patients between services. We are committed to ongoing collaboration on services for the benefit of our patients.
Communications
We recognise there is further work to do to raise awareness of the alternative options to our Emergency Departments to receive timely assessment and treatment and to build the confidence of our communities to access alternative services.
We are committed to clear, transparent and timely communication with our partners and wider communities.
The Phone First service for adults with minor injuries is operational for both Causeway and Antrim Emergency Departments and provides a first point of contact for advice, assessment and signposting to the most relevant local service.
Financial Constraints
Across Health and Social Care Services, there has been a sustained focus on maximising efficiency and productivity to deliver annual cost reductions and savings whilst balancing the needs of the community we serve. We are actively working to mitigate the impact of these savings for our patients and wider community.
Maximising Ambulance Capacity
Our Phone First doctor service will be in operation at Antrim and Causeway Hospitals to direct patient flow to Emergency Departments.
We will work together with the Northern Ireland Ambulance Service to ensure that our patients are handed over to our Emergency Department team in a timely way.
We will support enhanced pathways for the Northern Ireland Ambulance Service and focus on alternative pathways for primary care and from the Emergency Departments.
Our frailty teams will provide focused support to frail patients in our Emergency Departments.
Our teams will provide advice and support for staff and GPs working in residential homes to help prevent falls and ultimately to reduce the requirement for residents to attend an Emergency Department.
Reducing Time in Emergency Department
We will continue to raise awareness of other pathways such as specific respiratory and cardiology pathways which can either reduce the time spent in an Emergency Department or prevent the need for attendance.
We will develop bespoke care plans for patients with multiple attendances to prevent further attendances.
Our current pathways will be maximised through the use of rapid access arrangements and virtual clinics where appropriate.
Frailty Teams in Antrim and Causeway Hospitals will support Emergency Department staff in assessing elderly patients to determine the best care pathway.
Our Mental Health Liaison Team will provide an in-reach service to Antrim and Causeway Hospital Emergency Departments to ensure patients are assessed and treated as quickly as possible.
We will continue to improve patient flow through a co-ordinated approach to admission.
Timely Hospital Discharge
This Winter, we will continue to help patients discharge from hospital as soon as it is deemed appropriate by our clinical teams.
Our site co-ordination hubs at Antrim and Causeway Hospitals will continue to focus on expediting discharges and reducing delays.
Our Early Review Team will ensure patients with home care packages are reviewed quickly after discharge.
We will work with our independent sector providers to maximise care home bed availability including beds which offer an enhanced level of care for those with complex needs.
We will optimise the use of intermediate care beds to support patient discharge and support your recovery and independence.
Holistic assessments which include falls assessment and medication reviews will be carried out for our care home residents with recurrent falls.
Protecting Elective Care
Our daycase treatment, day surgery and ambulatory pathways will be maximised in order to reduce demands on inpatient beds.
We will continue to focus on optimising the elective theatre capacity.
We will ensure the funding allocation for additional waiting list activity is maximised.
Key Enablers
Protecting and Promoting Staff Health and Wellbeing
We are committed to building staff resilience and support staff through a comprehensive health and wellbeing strategy which provides a range of additional support.
We have a renewed focus on mental health and wellbeing.
We provide an influenza and COVID booster vaccination programme to staff.
We will encourage staff to take their breaks and annual leave.
Surge Preparation
We will prepare for surge through Trust Surge Plans and Business Continuity Plans.
Our risk assessments and Infection Prevention Control measures are key to keeping our patients and our staff safe
We will work with our staff to cover critical areas in times of pressure.
Monitoring and Reporting
We will use Enhanced Person Centred Observations (EPCO) across our wards to better understand our patient care needs.
We will optimise our community bed capacity through improved co-ordination and enhanced monitoring.
Careful management of additional supervision of patients in our hospitals and care homes will ensure consistent and appropriate support is provided.
Our Trust domiciliary care rotas will be maximised through regular review.