Preparing for winter

Published: 21 November 2017

Torbay and South Devon NHS Foundation Trust is preparing for increased demand for health and care services over the winter months by supporting local people to keep well and providing a range of alternatives to hospital admission. Viral infections such as flu and norovirus can sweep quickly through our communities and cause serious health issues for vulnerable adults and children, so the flu vaccination is being made available to all staff and we are encouraging local people to get their flu jab. We are also asking people not to visit our local hospitals if they are feeling unwell and we are enhancing our infection control and cleaning procedures as protective measures to prevent the spread of infection. Advice on falls prevention is widely available to help minimise the increase in falls and broken bones when the weather is icy.

We have a wide range of 7-day services now available in the community which we will be fully utilising to respond to the winter surge. We aim to avoid the need for a hospital admission and keep hospital stays to a safe minimum, instead of the usual NHS response of opening extra hospital beds. Deputy Medical Director, Joanne Watson, explains: “When people are acutely unwell, specialist hospital care is what they need, but it is not good to be in hospital when you don’t need that level of care. Research shows that just 10 days in hospital leads to the equivalent of 10 years of ageing in the muscles of people over 80. This is some of the evidence that supports our mantra that ‘the best bed is your own bed’. This year, thanks to investment in our new integrated care model, we have additional services and staff available to support people at home and in their local community. Our winter plan is all geared around supporting people to keep well and out of hospital – unless that is absolutely the best place for the care they need.”

The Trust is working on seven improvements to help keep services running smoothly over the busy winter months and to embed these changes in our model of care over the coming months:

• Increasing rapid response services and making best use of domiciliary care capacity
• Creating a single point of referral for discharge to streamline how our community teams proactively support people to leave hospital and reduce any delays
• Bringing together our district nursing and intermediate care nursing teams to support more people with complex needs in the community and at home
• Exploring how technology can help to identify the people most at risk of hospital admission, so we can better support them to stay well
• Providing new treatment and support pathways through ED, so we can treat and discharge more people on the same day, rather than admitting them to a hospital bed
• Setting up a winter leadership team of senior clinicians and managers to quickly respond to hospital pressures.
• Communicating effectively with staff, service users, carers, our partners and our public so that they have the information they need to make the best decisions

So there is a lot of preparation across our integrated health and social care services to better manage increased demand and make sure that local people continue to get the very best care over winter. There are some very specific additional services that are now available to manage winter pressures:

• Offering the free flu vaccine to pregnant women at their routine hospital ante-natal appointments
• Extending the opening times of our Emergency Ambulatory Unit (EAU) so that from 3 December this service will be open at the weekend as well as during the week. This unit takes referrals from GPs and avoids patients having to go to our Emergency Unit and senior doctors in the Emergency Department also refer people where their needs are better met by the specialist team working in this Unit. The EAU Team provide urgent medical assessment and care, and can organise onward care such as diagnostics or support at home to avoid a hospital admission.
• A new Rapid Access and Discharge Service (RADS) is now operating in our Emergency Department and short stay wards, supporting people after assessment by a senior doctor if they need further support but do not need to be admitted to hospital. The RADS team are made up of senior nurses, therapists and discharge co-ordinators. They undertake a comprehensive assessment of the patient’s physical, social and mental needs, and arrange onward care either at home or in a community setting.

Chief Executive, Mairead McAlinden, has made a direct, personal plea for help from the public to keep our hospitals infection-free. She said:

“We are working very hard to keep our hospitals and community services free from Norovirus and Influenza at this busy time of year. We assess every patient coming into our hospitals for any infection that could put themselves or others at risk, and when patients with an infection need to be admitted we quickly move them to designated beds to protect them and our other patients and staff. Our dedicated clinical and hospital cleaning staff work really hard to maintain our high standards of decontamination and infection control which limits any spread of infection. But we also need the help of our local community to keep our hospitals, care homes and community facilities as infection-free as possible. We know how much our patients appreciate visitors while they are in hospital, but if you are experiencing any infectious illness such as flu, vomiting or stomach upset, please do not visit until you are 48 hours symptom free. If you become unwell whilst visiting please inform a member of staff straightaway. By doing this, you will be helping us to keep our patients and staff safe and free from infection.”