Northern Health and Social Care Trust Winter Plan

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. We now have an additional 48 beds at Antrim Area Hospital which will help to ease the pressure on our Emergency Departments; however even with this extra capacity, we still 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. With our staff, we have developed a plan to take us through winter, focussing on three main areas.

Across Health and Social Care throughout the region, it has been agreed that these three areas should focus on   what has the most impact on how our services operate:

• 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 COVID or respiratory-related illness, preparations for industrial action, and comprehensive local and regional oversight arrangements.  This will help to ensure that primary and secondary care pathways are coordinated at a regional level, as well as working with the NI Ambulance Service to smooth any pressures and maintain patient flow and discharge.

Northern Trust Winter Preparedness Plan 2023/24

High Impact Areas

Maximising ambulance capacity

• A Phone First doctor service will be in operation at Antrim and Causeway Hospitals
• A Direct Advice Service for GPs is in place in the Causeway Locality
• Patients will be given scheduled appointments for urgent care
• Alternative handover locations for ambulance crews will be expanded, such as the establishment of a Direct Assessment Unit in Causeway Hospital
• Our teams will support GPs who are providing care to residents in residential homes
• Our teams will provide advice and support for staff in residential homes to help prevent falls which could result in a resident needing hospital treatment

Reducing time spent in Emergency Departments

• Rapid access cardiology and respiratory pathways will be established in Antrim Hospital
• The Frailty Teams in Antrim and Causeway Hospitals will support Emergency Department staff in assessing elderly patients to determine the best care pathway
• The Mental Health Liaison Team will provide a two hour response service to Antrim and Causeway Hospital Emergency Departments
• Bespoke care plans will be developed for High Intensity Users to prevent multiple attendances

Timely hospital discharge

• Site co-ordination hubs at Antrim and Causeway Hospitals will continue to focus on expediting discharges and reducing delays
• A newly developed dashboard will provide visibility across all community bed capacity
• The use of intermediate care beds will be optimised
• Weekly reviews of Trust domiciliary care rotas will be carried out
• Early reviews of domiciliary care packages will be carried out

Protecting Elective Care

• Daycase treatment, day surgery and ambulatory pathways will be maximised in order to reduce demands on inpatient beds
• Continued focus on service delivery plan targets and associated recovery plan
• Funding allocation for additional waiting list activity will be maximised
• Elective theatre capacity will be maximised

Key Enablers

Protecting and Promoting Staff Health and Wellbeing

• Rollout of influenza and COVID booster vaccination programme for staff
• Rollout of internal fit testing programme within key, priority areas
• Implementation of updated Staff Health, Wellbeing and Inclusion Strategy

Surge preparation

• Implementation of Trust Surge Plans and Business Continuity Plans, as required
• Risk assessments and Infection Prevention Control measures
• Activation of staff redeployment, as required

Preparation for Industrial Action

• Enhanced ‘Command & Control’ arrangements – Industrial Action operational planning group and strategic planning group in place, incident control meetings stood up during periods of Industrial Action
• and post-Industrial Action debriefs
• Updating of business impact assessments and Business
• Continuity plans
• Derogation meetings with Trade Unions
• Communication with staff, service users and wider public

Monitoring and reporting

• Enhanced monitoring of community bed capacity
• Implementation of Enhanced Person Centred Observations (EPCO) Project across all wards
• Testing of EPCO Project in care homes
• Development of an enhanced care panel for nursing and residential homes
• Weekly reviews of Trust domiciliary care rotas

Northern Trust Winter Plan 2023/24 (PDF)

Related Links

Department of Health: Winter pressures plan published