Learning from last winter

Health boards and the Scottish Government have already begun planning for the additional pressures winter brings, Health Secretary Shona Robison said today.

A review of winter 2014/15 published today offers insight into how last winter impacted on NHS services, with more activity in our hospitals and significant pressures from flu and respiratory illness.

It comes as the Scottish Government issues guidance for winter 2015/16 to all health boards.

Analysis of last winter is reflected in this year’s winter guidance, including having plans in place for additional winter beds, ensuring patients can be appropriately discharged at weekends and bank holidays and having an approach that focusses on the whole system – not just emergency care.

The Scottish Government will continue to engage with health boards on planning for winter, with NHS Boards due to publish their winter plans in October.

Speaking ahead of a visit to Dumfries and Galloway Royal Infirmary, Health Secretary Shona Robison thanked NHS staff for their fantastic efforts not only last winter but all year round.

She said it was important health boards drew on the lessons learned from last year’s challenging winter and were on the front foot this year.

Ms Robison said:

“We know that the winter months are always more challenging for our health boards, with today’s report showing that hospitals saw more, sicker, people last winter compared to previous years.

“With more people now living with long term conditions and a growing number of older people with multiple conditions and complex needs, it is vital that we learn from the lessons of last winter and have robust plans in place not only for this winter, but throughout the year.

“We know that the increased pressure on our emergency departments led to health boards having to cancel some elective procedures, which is why we’re asking boards for whole system activity plans for winter.

“Our guidance also asks boards to have in place strategies for staffing additional capacity to maintain progress towards minimising delays in discharging patients.

“This includes ensuring there are effective systems in place to discharge patients at the weekend and over the festive period and coping with peaks in demand.

"Tackling delays in patients being discharged from hospital is clearly a crucial part of easing pressure on the system and it is reassuring to see that delays over three days dropped by 12 per cent in April 2015 when compared to the year before.

“A&E waiting times performance was down on recent winters, but we should note emergency departments across the country have improved steadily over recent months – and the latest figures are now better than at this point last year. Scotland had a better core A&E waiting times performance than the rest of the UK last winter, with performance slightly better than England and significantly above Northern Ireland and Wales.

“Staffing levels between December 2013 and December 2014 also increased, with the NHS Scotland workforce growing by 1.8 per cent, or 2,495.6 whole time equivalent members of staff. There has also been significant developments in nursing and midwifery workload and workforce planning tools over recent years which allows health boards to determine staffing requirements.

“This is the earliest we have issued winter guidance and we will continue to work closely with health boards as we head into winter to learn from and build on the lessons learned from last year.

“We are also asking boards to publish their winter plans by the end of October.”

During the Health Secretary’s visit to Dumfries and Galloway Royal Infirmary, she heard about the ‘seven day discharge approach’ that was implemented over the winter months, which aimed to increase the number of patients discharged over the weekend and improve flow through the hospital, it also supported an increase in morning discharges. As a result NHS D&G saw the number of patients discharged improve compared to the same period the previous year.

Deputy Chair of NHS Dumfries and Galloway, Penny Halliday, said:

“Staff and management worked together to ensure that we had plans in place to deal with the increased pressure placed on services during the winter months. Their efforts meant that despite higher number of patients being admitted to hospital in Dumfries and Galloway their waiting times and hospital stays were shorter than in previous years.”

Chief Executive of NHS Dumfries and Galloway, Jeff Ace, said:

“The seven day discharge pilot we undertook in partnership with social work and the Scottish Ambulance Service worked well and we were able to send people home as soon as they were well enough to go. This guidance from the Scottish Government will assist the Dumfries and Galloway partnership in planning for the increased numbers of complex patients requiring support over the winter months.”