Taking a Patient FIRST approach to winter planning

Professor Ted Baker discusses our new resource, Patient FIRST, and how we’ll be getting in touch with NHS trusts to discuss how they are planning for winter.

I wanted to start by thanking you again for your continued efforts as we manage the coronavirus pandemic. We continue to see people going above and beyond, using innovative and new ways of delivering services to meet peoples’ needs in a safe and effective way.

We are already seeing winter pressures mounting. I am concerned that these pressures are building to a peak more quickly than usual, and that some hospital emergency departments are experiencing issues with flow earlier than they have in previous winters. This reflects the clear impact of increased demand combined with infection prevention and control measures required to safely manage the ongoing coronavirus pandemic, and the need to reinstate elective care — which was put on hold at the peak of the crisis.

During winter in particular, there is often a focus on the performance of emergency departments. But solutions cannot be found here alone, or within the hospital alone. Managing winter pressures requires a system-wide response.

It was with this in mind that we recently published Patient FIRST. This important resource was developed in partnership with a group of frontline clinicians from good and outstanding emergency departments across the country. It looks to support those working in NHS trusts and the wider health and care system to understand what lessons can be learnt from the impact of the pandemic, and what good practice can be harnessed to support improvement.

It focuses on five key areas:

• Flow
• Infection control, including social distancing
• Reduced numbers of patients to the emergency department
• Staffing
• Treatment

It suggests actions that can be taken at a departmental, trust and wider system level to maximise capacity, maintain effective patient flow, and keep staff and patients safe.

I am pleased to have had a positive response to this publication from so many of you, and we have heard that it is already being used by clinical teams. It is important that NHS trust boards are also sighted on this document, and I would encourage you to read it if you have not yet had the chance to do so. Executive teams have a key role in supporting Patient FIRST, and in empowering the whole hospital and their local systems to implement some of the actions or suggest their own solutions.

Building on this, it is an ideal time to be talking about your plans for winter. Our inspection teams will be getting in touch to arrange conversations as part of our transitional monitoring approach, which we plan to have completed in the coming weeks. Conversations will be structured around our existing Key Lines of Enquiry (KLOEs) and are to help us understand the issues and challenges you’re facing, and how you’re responding. They will give you the opportunity to talk us through the plans you have in place for winter, the initiatives and solutions you’ve already implemented as part of a system and across your hospital.

You can visit our website to find out more about what to expect from the transitional monitoring approach, and see the questions we’ll ask NHS trust level urgent and emergency care services.