CRITICAL CARE TASK FINISH GROUP TRANSFERS WORKSTREAM EASC

CRITICAL CARE TASK & FINISH GROUP TRANSFERS WORKSTREAM EASC IMPLEMENTATION PLANS NATIONAL COLLABORATIVE COMMISSIONING UNIT

ALL WALES TRANSFER & DISCHARGE MODEL • • • No reliance on frontline WAST assets (therefore minimal delays). No depletion of hospital/HB frontline staff; workforce prudency. Improving flow for all hospitals but especially the tertiary centres. Compliance with Designed for Life: Welsh Guidelines for the transfer of the critically ill adult. Another tier to EMRTS, adding resilience. Can be used for the critically ill e. g. cardiac/PPCI, vascular etc. (not just critical care). It is likely that Medical Staffing will be very difficult as most Doctors are already fully job-planned with little scope for additional duties so the key risk here is medical staff recruitment; • Anaesthetic consultants in Wales are prepared to re-job plan to take on this work? • The anaesthesia STC is in a position to allocate trainees to staff the model? • The creation of fellowships for NCCGs can be functionally operationalised? If the answer to the above is not favourable, then the only likely way to staff the option would involve locum/WLI remuneration (even this is at risk with the recent taxation laws). This could be actioned as an interim while fellowships are created, and while the deanery/STC reorganise their training programme. This is however a costly service and using locum will increase those costs. It should be noted that no model would be able to get to all of the patients all of the time and that hospital staff will need to retain skills for occasions when they do need to undertake a transfer. An additional recommendation is that no capacity or non-urgent transfers will be undertaken out of hours (20. 00 – 08. 00 hrs). Critical Care Transfers Workstream recommendations

ALL WALES TRANSFER & DISCHARGE MODEL EASC IMTP • • National Collaborative Commissioning: Quality & Delivery Frameworks. Scoping a National Transfer & Discharge Service with following elements: o Adult critical care o Major trauma repatriations o Stroke Thrombectomy repatriations o Mental health transport o Inter hospital transfers (GUH)

ALL WALES TRANSFER & DISCHARGE MODEL Adult critical care proposal development • • • Outline business case developed with EMRTS Cymru Parallel service within EMRTS Cymru Collaboration between EASC, EMRTS Cymru & WAST Business case requires further development North & South Wales provision Dedicated/specialist resources for the service

ALL WALES TRANSFER & DISCHARGE MODEL Critical Care Transfer Model EASC • Commissioning allocation is adequate to deliver the service • National Commissioning arrangements & programme management through EASC WAST • T&F Group to develop interim arrangements • Fleet & vehicle procurement Critical Care Transfers EMRTS • Clinical lead • Registrar level doctors • Retrieval & Transer Practitioners

ALL WALES TRANSFER & DISCHARGE MODEL Implementation plan: Next steps Programme workstreams: • Referral pathways • Research and audit • Commissioning • Communication and engagement • Handover and information flow • Recruitment, induction and training • Clinical SOPs • Capital and infrastructure • Infectious disease and Infection control • Organisational structures and rotas • Pharmacy • Education and training • Vehicle Design and clinical equipment Critical Care Transfers EASC, EMRTS & WAST • Appoint programme & clinical lead • T&F Group to develop interim arrangements

ALL WALES TRANSFER & DISCHARGE MODEL Questions