This weekend has seen me as the Operational commander for the local East Dorset sector.
Our patch is fairly unique within SWAST as it has two acute hospitals within one sector at either end of the Bournemouth , Poole conurbation.
This can prove challenging especially when both hospitals are struggling to off load ambulances. Yesterday saw handover delays at both hospitals, luckily we had additional operational officer cover yesterday which allowed us to have an ops officer at each hospital to liaise with the hospital staff and manage delays.
This was in addition to the team providing incident command support at a evacuation of a local swimming pool and leisure complex and at a complex trauma incident.
For those of you who hate the thought of Christmas look away now apparently its about 90 odd days away and counting, Christmas goods are in the shops! From an ambulance service and NHS wide perspective this means finalising plans to deal with anticipated winter pressures. This include plans to deal with increased numbers of 999 and 111 calls, handover delays at hospitals , disruption to services due to severe weather, planning for large gatherings on New years Eve, alongside our business as usual functions. This is part of the role of our Emergency Preparedness, Resilience and Response team who work closely with local managers, other agencies and NHS trusts to ensure we have robust pans in place to cope with expected pressures. The acute hospitals will also be forming their plans and they will look at expediting discharges, creating extra bed capacity and additional staffing at key times.to ensure that they maintain bed capacity in the hospitals. Jointly and nationally there are many initiatives in place for admission avoidance. As you can see a lot of work goes on behind the scenes to make sure that patients receive the care that they need at the right time in the appropriate setting.
That's it from me for this week off for two days of training next week before covering the weekend.
Sunday, 25 September 2016
Sunday, 18 September 2016
Frequent callers
Risk assessments has been the main job this week. I have been completing the health and safety risk assessments across the three stations in our sector. Overall no real major problems identified but a wish list prepared for the estates team. There is one major piece of work related to this I am continuing with and more about that in the future.
If you are a regular reader of my blog (apparently there are some!) my last ramblings talked about the efforts made to reduce the volume of frequent callers. I attended a multi disciplinary meeting this week for one of the top five frequent callers for Dorset. Other agencies represented were the patients GP, community matron, Community mental heath team, district nursing team, physiotherapists and social services. This was to ensure that all agencies could share information and agree a joint approach.
This part of the process was to ask the the patient to sign a Acceptable Behaviour Contract. This is a voluntary agreement between the patient and the Trust with several clauses, all of which revolve around reduction in calls to the ambulance service and requiring engagement with other support services. It also requires the patient to be polite and non threatening to NHS staff whether in person or on the phone. Despite the patients GP visiting the patient several times in the run up to the meeting, the patient did not attend and a further date has been organised for the GP and myself to visit the patient at home.
I will reiterate at this point, this whole process is to try to ensure the patient is engaging with the services available to them. This ensures that they receive the help and assistance they need. If this is in place the patient benefits and as a service we normally see a reduction in our call rate.
The frequent callers often pose difficulties to all agencies involved in both their care and social situation. This often leads to the police being involved and they also have a similar process in place. In the past the agencies probably would have worked in isolation and the combined multi agency approach we now use ensures that these patients are not slipping through the net or being missed due to lack of information sharing. The ambulance service is often the first port of call for many of these patients and without the hard work of our small frequent caller team many of these patients would not be highlighted to the teams involved in their care.
I have a few days off this week with lots planned so whatever you are doing stay safe and have fun.
If you are a regular reader of my blog (apparently there are some!) my last ramblings talked about the efforts made to reduce the volume of frequent callers. I attended a multi disciplinary meeting this week for one of the top five frequent callers for Dorset. Other agencies represented were the patients GP, community matron, Community mental heath team, district nursing team, physiotherapists and social services. This was to ensure that all agencies could share information and agree a joint approach.
This part of the process was to ask the the patient to sign a Acceptable Behaviour Contract. This is a voluntary agreement between the patient and the Trust with several clauses, all of which revolve around reduction in calls to the ambulance service and requiring engagement with other support services. It also requires the patient to be polite and non threatening to NHS staff whether in person or on the phone. Despite the patients GP visiting the patient several times in the run up to the meeting, the patient did not attend and a further date has been organised for the GP and myself to visit the patient at home.
I will reiterate at this point, this whole process is to try to ensure the patient is engaging with the services available to them. This ensures that they receive the help and assistance they need. If this is in place the patient benefits and as a service we normally see a reduction in our call rate.
The frequent callers often pose difficulties to all agencies involved in both their care and social situation. This often leads to the police being involved and they also have a similar process in place. In the past the agencies probably would have worked in isolation and the combined multi agency approach we now use ensures that these patients are not slipping through the net or being missed due to lack of information sharing. The ambulance service is often the first port of call for many of these patients and without the hard work of our small frequent caller team many of these patients would not be highlighted to the teams involved in their care.
I have a few days off this week with lots planned so whatever you are doing stay safe and have fun.
Friday, 9 September 2016
Hectic
Back from my leave and despite the school holidays finishing demand is still up and the NHS as a whole is still very busy.
I have been involved with dealing with a "frequent caller" this week. This is some one who is contacting 999, 111 or the out of hours GP service on a regular basis, they may also be contacting the police. To reduce these call levels the trust have a dedicated team who identify this type of caller this information is then passed to the local operations teams who attend meetings etc on behalf of the trust.
Once identified the trust will contact the patients GP to gain more information about them. Often the increase in calls is due to patient having a ongoing medical problem which may have worsened or changed in the way it is presenting. It may give new symptoms including falls or pain. Often with the help of the GP and other agencies these callers can receive the help assistance or changes to medication that they need. It may be that the level of home care they are receiving needs to increased or the times of visits altered to help avoid falls.
However there are those that despite this combined approach their call volume continue to increase at this point the team write to the patient and their GP to inform them of the continued number of high calls and again to try to identify the cause for this continued call volume. At this stage often a multi disciplinary, multi agency meeting may be held to discuss and review the patient.
To put this in perspective at this point it is likely that these patient will be calling 999, 111 or the out of hours service at least once a day if not more, on average. At this type of meeting all agencies and healthcare professionals involved with the patient will be represented and information , current treatments and inputs from community teams will be discussed to see if there is more that can be done for the patient. Often these patients will be well known to the teams and alternative care plans will be formed to try to help these patients.
The patients well being is central to these discussions as there is normally an underlying reason for there call volume and there are multiple methods that may be used to try to gain the patient the help that they need from one or multiple agencies or disciplines.
If that fails to reduce the call volume further action then take place and I will outline those in my next blog.
I hope you have all had a good few weeks while I have been away.
I have been involved with dealing with a "frequent caller" this week. This is some one who is contacting 999, 111 or the out of hours GP service on a regular basis, they may also be contacting the police. To reduce these call levels the trust have a dedicated team who identify this type of caller this information is then passed to the local operations teams who attend meetings etc on behalf of the trust.
Once identified the trust will contact the patients GP to gain more information about them. Often the increase in calls is due to patient having a ongoing medical problem which may have worsened or changed in the way it is presenting. It may give new symptoms including falls or pain. Often with the help of the GP and other agencies these callers can receive the help assistance or changes to medication that they need. It may be that the level of home care they are receiving needs to increased or the times of visits altered to help avoid falls.
However there are those that despite this combined approach their call volume continue to increase at this point the team write to the patient and their GP to inform them of the continued number of high calls and again to try to identify the cause for this continued call volume. At this stage often a multi disciplinary, multi agency meeting may be held to discuss and review the patient.
To put this in perspective at this point it is likely that these patient will be calling 999, 111 or the out of hours service at least once a day if not more, on average. At this type of meeting all agencies and healthcare professionals involved with the patient will be represented and information , current treatments and inputs from community teams will be discussed to see if there is more that can be done for the patient. Often these patients will be well known to the teams and alternative care plans will be formed to try to help these patients.
The patients well being is central to these discussions as there is normally an underlying reason for there call volume and there are multiple methods that may be used to try to gain the patient the help that they need from one or multiple agencies or disciplines.
If that fails to reduce the call volume further action then take place and I will outline those in my next blog.
I hope you have all had a good few weeks while I have been away.
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