WALES CRITICAL CARE & TRAUMA NETWORK

Transcription

1 WALES CRITICAL CARE & TRAUMA NETWORK (North) EMERGENCY PLANNING GROUP Wednesday 15 th November :30-16:30hrs Venue: Room 3, Residents Block, Abergele Hospital Minutes Present: Chris Littler, Consultant Intensivist, ICU, WM Chairperson Ian Johnson, Consultant Intensivist, YG John Glen, Consultant Intensivist, YGC Mark Williams-Jones, Senior Nurse Manager, YGC Emma Bins, Business Continuity Manager, BCUHB Danny Jones, Anaesthetic Matron, WM Joanne White, PDN, YGC Nicola Vaughan-Jones, PDN, YG 1. Welcome and Apologies George Bugelli, Helen Williams, Aradhana Ingley 2. Minutes of the last meeting The minutes of the last meeting held on the 7 th December 2016 were accepted as a true and accurate record. however apologised for not arranging a meeting earlier in the year as previously minuted. 3. Matters Arising Agenda Item Actions from the Minutes of 7 th December 2016 By Whom Update 3.1 Stuart D arcy (Microbiologist) to be contacted and his response forwarded to JG and IJ. CL to contact Stuart D arcy regarding mask cleaning 3.2 YGC major incident plans to be streamlined and focused on critical care. Link to be added to the top of the YGC escalation plans as to where to find the full action cards. to double check with JG if completed 3.3 Link to be added to the top of the YG major incident plans as to where to find the full action cards. EFH/IJ to double check if completed 3.4 Appendix 4 (now 3) to be reviewed with Paul Bains. CL to Kate Parkins from NWTS. 3.5 EFH reported from CCIG meeting Consultant from Bristol wishing for Adult ICUs to take paeds (he felt it was safer to have paeds in ICU rather than theatre/recovery). The CCIG felt that each individual hospital should have their own plans. VOK will also ask Shohba as she has contacts in Alder Hey CL EFH/IJ CL VOK CL commented that he hadn t contacted Stuart D Arcy Complete on agenda. Precis of each hospitals MI plans to be incorporated into Network plans. As above had tried to contact Kate Parkins with no response. to contact Rachael Barber for help with this action. Action 3.1: to contact Rachael Barber to ask her to review Paediatric Guidelines Superseded: noted that both Chair of the CIIG and the Cheshire & Mersey Network wish to know BCU plans for escalation of paediatrics in the event of the tertiary centre being full. She also noted that Steve Moore will be writing to Evan Moore requesting formal feedback. This has already been discussed in SIG and being actioned by this group. Action 3.2: SS,RP/JG,EFH to draft guidance. to include as appendix in Emergency Planning Guidelines 3.6 EB to be requested Mass Casualty Plan EB HB Plan being revised. 3.7 EB Draft ED Business Continuity Plans to be forwarded to. 3.8 to chase business continuity plans from EB EB Complete: ed 5 th January 2017 awaiting reply 1

2 3.9 /RET/LK to add to agenda for next meeting in Spring; business continuity plans using [old] template from WM /RE T/LK 4.1 to double check wording regarding CC bed allocation from WG requirements; is it per HB or per hospital. 4.2 to draft letter for CL and to send to Meinir to let her know about escalation issue. 4.3 to revise guidelines reflecting change in bed allocation and also phased responses 4.4 CL and GB/JG to review where Level 2 patients go if in full escalation. 4.4 CL and GB/JG to review where Level 2 patients go if in full escalation. 5.1 to revise accordingly and send to Evan Moore 6.1 to embed revised documents (as per above). 2 Complete: ed 5 th January 2017 CL/JG/G B Complete Escalation plans submitted to QSE. They request paragraph where Level 2 patients go if in full escalation. On agenda 4. Emergency Planning Guidelines discussed the Emergency Planning guidelines with the group. To avoid the Guidelines becoming too bulky and cumbersome it was agreed to amend the Guidelines to include a precis of the Critical Care requirements. advised that she will circulate JGs recent to CL and IJ for guidance. Action 4.1: to circulate JG s to CL/IJ re: action cards for precis commented that following the introduction of the new All Wales CC&TN website, the links (page 48) require to be amended to reflect new website address Action 4.2: RT to update page 48 with new website address JW commented that she will confirm the Critical Care unit phone numbers and feedback to RT Action 4.3: JW send phone numbers to RT for RT to correct if necessary 5. Escalation Plans commented that in the Escalation Plans For Generic Requirements she had amended the narrative in January 2017, removed CPG and revised the wording to align with WG. Following a discussion it was agreed: Green level: YG to be amended to 6 and 5 beds. Yellow level: YG to be amended to 6 and 2 beds, WM to be amended to advise 2 beds up to level 3. Amber level: Advised extra staff required, YG to be amended to 6 and 7 beds. Action 5.1: /RT to amend the figures pertaining to bed numbers Action 5.2: to ensure all three Emergency Planning, Escalation Plan and Escalation Plan & Triage Tool for Pandemic Flu align accordingly. 6. Escalation Plan & Triage Tool for Pandemic Flu CL presented the Escalation Plan & Triage Tool for Pandemic Flu at the September QSE meeting however they wished for further narrative regarding the provision for level 2 patients where there has been escalation of level 3 in level 2 bed spaces. IJ advised, for YG, that mostly the patients are downgraded to level 1, or a combination of converting to level 1 or level 1+ and transferred to the ward. CL confirmed that he has discussed patients going to recovery. Therefore it was agreed level 2 patients are to be sent to recovery and/or downgraded to level 1, they will have the support of AIT, ODPs and anaesthetic staff where available. Action 5.2: /RT to amend numbers and transfer over to the pandemic flu guidelines IJ advised using other staff in the Network if a major incident were to occur, and that level 2 patients should be transferred, which it was agreed to be considered first. The Escalation Plan & Triage Tool for Pandemic Flu will need to be submitted to the next QSE meeting

3 Action 6.1: RT to find out next QSE meeting date and feedback to CL Action 6.2: CL to present The Escalation Plan & Triage Tool for Pandemic Flu at the next QSE meeting 7. NHS England Managing influenza in Critical Care commented that, although the document is NHS England it has been circulated to the group for information and for possible alignment if anything is missed out of the BCU documents. She further remarked that she has not seen any similar publication in NHS Wales. 8. Winter Pressures Planning DJ, MWJ and NVJ cited no issues to report and normal winter planning is being undertaken. 9. Business Continuity Plans EB commented that she has recently sent the Business Continuity Plan through for circulation and approval with regards to business impact and analysis. She commented that consideration and discussion is required with theatres in relation to the possible use of a decant area for Critical Care patients. EB remarked that she has recently met with theatres managers for YG and YGC, who are unaware of the current escalation plans for Critical Care. CL advised that this agreement is historical in WM, however that the plan is old and theatre management has changed. EB advised that the WM manager was not present at the meeting she held, so was unable to comment with regards to WM. requested JG and MW-J to communicate with theatre managers in YGC. Action 9.1: JG and MW-J to meet with theatre managers re: decant area queried whether the approval for the Business Continuity Plan requires to be a separate meeting. CL remarked that a further Emergency Planning meeting should be organised for early in the New Year. Action 9.2: RT to add Critical Care Business Continuity Plan approval on to next agenda 10. Feedback from the Midlands Mass Casualty Event commented that the recent Mass Casualty Event was held at Birmingham City Football Club on the 13 th October She noted it was a good event however there was not a large portrayal of lessons learned. There are to be further events in relation to preparation for major incident: NHS response to Manchester bomb 21 st November 2017, Graham Mayers is attending on behalf of BCU. Health prepared 27 th November 2017 in Cardiff. This is to be a look back at incidents across UK. It was commented that Emergency Planning leads and IJ are to attend. CL requested information to be sent to him. Action 10.1: EB to send CL information on Health Prepared on the 27 th November fedback lessons learned to the group from Rachael Barber s talk on the Manchester attack at the recent Critical Care Study Day on the 14 th November: WhatsApp, nurses have set up using WhatsApp to bleep nurses. Patient ID, staff using different patient numbers (consistency required) JG advised when MI declared every patient is numbered and considered part of MI plan. Dummy run use of practice runs Critical Care trolleys ready to receive patients not stabilised as moving quickly through department, this may be more relevant for paediatrics. Other patients general physicians aided Radiologists use more than one person to avoid psychological trauma of reviewing trauma scans Dignitaries visit Ensure a specific team to receive (communications team) 11. CitizenAid, as an ambassador for CitizenAid, updated the group with regards to a free app which is available on mobile phones. This app advises what to do in event of emergency situation. requested the group to promote as it is particularly useful for non clinical people. Action 11.1: The group to promote the use of the CitizenAid app 3

4 12. AOB Pandemic Influenza commented on the PISA document, which is not specific to Critical Care but has been circulated from the Welsh Health Organisation. Madagascan Plague Andy Campbell circulated a related document. confirmed she will send out to the group. JW advised YGC have already circulated it throughout the critical care unit at YGC. Action 12.1: to send the document relating to Madagascan plague to ICU leads 13. Date & Venue of Next Meeting : It was agreed to hold the next meeting on Thursday 1 st February 2018 RT will circulate VC numbers however staff need to book rooms if wishing to VC. Action 13.1: RT to circulate VC numbers for next meeting :

5 Action Card Emergency Planning Minutes of the 15 th November 2017 Agenda Item By Whom 3.1 to contact Rachael Barber to ask her to review Paediatric Guidelines 3.2 SS,RP/JG,EFH to draft guidance. to include as appendix in Emergency Planning Guidelines SS,RP/JG, EFH 4.1 to circulate JG s to CL/IJ re: action cards for precis 4.2 RT to update page 48 with new website address RT 4.3 JW send phone numbers to RT for RT to correct if necessary JW 5.1 /RT to amend the figures pertaining to bed numbers /RT 5.2 to ensure all three Emergency Planning, Escalation Plan and Escalation Plan & Triage Tool for Pandemic Flu align accordingly. 6.1 RT to find out next Q&S meeting date and feedback to CL RT 6.2 CL to present The Escalation Plan & Triage Tool for Pandemic Flu at the next QSE meeting CL 9.1 JG and MW-J to meet with theatre managers re: decant area JG/MW-J 9.2 RT to add Critical Care Business Continuity Plan approval to next agenda RT 10.1 EB to send CL information on Health Prepared on the 27th November EB 11.1 The group to promote the use of the CitizenAid app All 12.1 to send the document relating to Madagascan plague to ICU leads 13.1 RT to circulate VC numbers for next meeting : RT 5