Managing with Extreme Weather Ralph Roberts Chief Operating Officer.

Managing with Extreme

Weather

Ralph Roberts

Chief Operating Officer

NHS Borders - Context

• Smallest mainland Health Board in Scotland

1 DGH4 Community

Hospitals24 GP Practices

Single LA

New Chief Executive

2 new Executive Directors

• Population – 110,000• 1800 Square Miles• 65% of the population

live outside settlements of 10,000 people, (28% for Scotland)

Monday 4th January

• Public Holiday

• Review of “Festive period”

– A&E @ 99%

– A&E activity down 9%

– 60 beds fewer across system

– 9% fewer admissions

– Discharges / admissions in balance

• cold spell over festive period

Tuesday 5th January

• Planned reduction in Elective Activity – URGENTS only

• New Executive Team meeting

• Schools closed – access

• SBC Emergency Co-ordination group –

review forecast / school opening

• Extreme weather NOT forecast overnight

Wednesday 6th Jan

• Heavy snowfall (15cm)

• freezing temps ( -14 c)

• Most B & C class roads impassable

• A Class roads – 4 WD only

Wednesday 6th Jan: Early AM

•06:30 – BGH Staffing issues escalated

• Emergency Services only / Public Communication

• Facilities for Night Staff

• 09:00 – HQ closed – Crisis Management Team at BGH

Wednesday 6th Jan: AM

• Establish Crisis Management Team

• SBC Strategic Co-ordinating Group – “the bunker”

• Staffing / Service review by site

• Electives for 7th January

• Information / Public Communication

• Late shift Staffing

Wednesday 6th Jan: PM

• Supplies

• Information / Public Communication

• Emergency Retrieval

• Helicopter

• Out of Hours transport

Wednesday 6th Jan: PM

• Supplies

• Information / Public Communication

• Emergency Retrieval

• Helicopter

• Out of Hours transport

•Night staff

• Initial Transport review

• Planning for 7th Jan

Thursday 7th Jan

• Limited additional snow

• Temp remain around -10 c

• Most B & C roads closed all day

• A class roads passable from mid afternoon

Thursday 7th Jan

• Crisis Management Team

• Staffing – 2 shifts ahead

• Transport Hub

• Patient transport

Thursday 7th Jan

• Crisis Management Team

• Staffing – 2 shifts ahead

• Transport Hub

• Patient transport

• Non emergency activity for Friday ?

• Emergency Retrieval

Thursday 7th Jan

• Crisis Management Team

• Staffing – 2 shifts ahead

• Transport Hub

• Patient transport

• Non Emergency services for Friday ?

• Emergency Retrieval

• Crisis team / Operational teams

Friday 8th Jan

• Elective services operating

• HQ re-opened

• Recovery phase

Friday 8th Jan

• Elective services operating

• HQ re-opened

• Recovery phase

• Weekend Plans

• “counting the cost”

• Public Communications

Lessons - SystemsBusiness Continuity Plans

- initial escalation- scenarios- communication / Crisis Team

- Information / IM&T- Decision Log

Lessons - SystemsBusiness Continuity Plans

- initial escalation- scenarios- communication / Crisis Team

- Information / IM&T- Decision Log

Transport- access to 4WD- supplies

Lessons - SystemsBusiness Continuity Plans

- initial escalation- scenarios- communication / Crisis Team

- Information / IM&T- Decision Log

Transport- access to 4WD- supplies

Multi Agency links

Lessons - SystemsBusiness Continuity Plans

- initial escalation- scenarios- communication / Crisis Team

- Information / IM&T- Decision Log

Transport- access to 4WD- supplies

Multi Agency links

Specific patient groups- Vulnerable- Cancer- Dialysis- Emergency retrieval

Lessons - Staff

Rate limiting factor

Junior Doctors

Contact

Transport

Flexibility

Variability

Policies / FAQs

Lessons - Communications

Positive

Control

Simple messages

Focus

Staff

The big freeze grips the region

True grit needed as big chillGrips the region

Town is “cut off” as snowWreaks havoc

Winter White Out

Life - Savers

Valiant efforts tackleSnowfall in Scottish Borders

Snow hits stricken helicopterfor six

Borders snow clearancebattle continues

Keeping warm and wellin the cold snap

Community spirit helped elderly survive Sea King returns to the skies

Supplies on a sledge for hospital patients

Exceptional efforts of NHS Borders Workers during the big freeze

NHS Borders staff go the extra mile NHS Borders: Normal

service resumes

Thank You

Questions ?