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Surge Capacity

Surge Capacity. Secondary & Community care, mental health & learning disability (Trusts). Ensuring readiness. PHA/HSCB/BSO Surge Assessment group Reviewed Trust Plans Regional workshop mid-June Trust self-assessment checklists Report on readiness 30 th June Plans resubmitted end July

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Surge Capacity

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  1. Surge Capacity Secondary & Community care, mental health & learning disability (Trusts)

  2. Ensuring readiness • PHA/HSCB/BSO Surge Assessment group • Reviewed Trust Plans • Regional workshop mid-June • Trust self-assessment checklists • Report on readiness 30th June • Plans resubmitted end July • Face to face meetings with Trusts • Resubmitted checklists – significant progress • Surge assessment report to next programme Board

  3. Regional Business Cases • Virology equipment & staff • Critical care expansion • Adult • Paediatric • Neonatal intensive care expansion • Nursing & AHP training • Appointment of staff to nurse banks • Community respiratory equipment • Beds & mattresses • Other community equipment

  4. Critical Care CapacityEstimated demand for critical care admission in NI • Scenarios • 30% Clinical Attack Rate, 2% hospitalisation rate & 25% critical care admission (all age groups) • 50% CAR, 2% hospitalisation rate & 25% cc admission rate (children) • 50% CAR, 1% hospitalisation rate & 25% admission rate (children)

  5. Critical Care CapacityEstimated demand for critical care admission in NI

  6. Additional paediatric critical care beds needed in peak week (7 day average length of stay & 98% occupancy)

  7. Critical care expansion plans • Adult ICU beds - currently 57 + 13 CSICU During peak surge will rise to 158 (increase of 126%) Requires 47 extra ventilators and 215 pumps @ £1.4m • Paediatric ICU beds – currently 8 in RBHSC During peak surge will rise to 29 in BHSCT plus 20 in DGHs (increase of 510%) Requires 38 extra ventilators and 220 pumps @ £1.6m • Neonatal (level 1) beds – currently 21 During peak surge will rise to 63 (increase of 200%) Requires 36 extra ventilators & 179 pumps @ £2.3m

  8. Challenges • Critical Care capacity versus demand • Application of triage (SOFA) and reverse triage • As yet no agreed triage process for children • Uncertainty on scale of cases of premature labour & hence neonatal demand • Lead time for equipment procurement • Phasing of increased critical care capacity (staff ratios & locations) • Firm plans for staff redeployment (no double-counting)

  9. Challenges • Ensuring PPE availability and match to fit-testing • Time for staff to have training for redeployment • Core regional services – equity of access • Timing of turndown of elective work • Business case processes • Variation in Trust proposals (quantity and costs) to deliver similar services • Capacity of Trusts to develop cases to DHSSPS standards • Public (& professional) expectation • Timely & transparent communication to the public & professionals of changes in service access

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