RE: Freedom of Information Request 202021 / 087 - Covid-19 Emails / Care Homes
Your Query Date of Request July 2020 Under Freedom of Information legislation, I would like
1. All emails/correspondence with the Scottish Government relating to the freeing up hospital beds to create space for coronavirus patients from February this year to April 27….
2. Also please can you tell me how many patients in your area were moved from hospital to care homes without being tested for coronavirus from February 1st to April 27….
Response 1. Please note that not all emails/correspondence are available due to inbox clearing; therefore I must advise that in terms of Section 17 of the Freedom of Information (Scotland) Act 2002, some of the information sought is not held.
NHS Orkney can provide the following correspondence:
Appendix 1 - COVID-19 – CURRENT AND SURGE BED CAPACITY – 04/03/2020 Appendix 2 - MOBILISATION PLANS – 11/03/2020 Appendix 3 - NHS Chief Executives Business Meeting – 11/03/2020 Appendix 4 - REVISED MOBILISATION PLANS – INFORMATION ON ICU CAPACITY AND ACUTE BED OCCUPANCY – 05/04/2020 Appendix 5 - CE Designate Letter J Connaghan re ICU Capacity & Acute Bed Capacity - 06/04/20 Appendix 6 - COVID-19: NHS BOARD MOBILISATION PLANS: ACUTE BED CAPACITY – 09/04/2020
2. 16 patients were moved from hospital to care homes without being tested for coronavirus from February 1st to April 27th 2020.
Appendix 1 Health Performance and Delivery Directorate Chief Performance Officer, NHSScotland and Director of Delivery and Resilience
T: 0131-244 2480 E: [email protected]
Chief Executives of NHS Boards
___ 4 March 2020 Dear Colleague
COVID-19 – CURRENT AND SURGE BED CAPACITY
This letter follows up previous correspondence from Malcolm Wright CEO and DG which referenced a request that would be made to Boards in relation to current bed capacity and potential surge capacity for the purposes of response to C-19. This letter requests that you supply that information by 5pm Friday 6 March.
Attached are two excel spreadsheet templates. Please note the following in completing these
(a) Columns 1-6 should contain information on the total bed complement for your Board (by site/specialty/bed type).
(b) Columns 7-12 should contain your assessment of how many of these beds are immediately available for C-19 patients assuming that there is no cessation of normal patient activity (ie elective/unscheduled care continues).
(c) Columns 13-18 should contain your assessment of how your total bed capacity could be expanded assuming all non-essential activity is suspended. In addition we request that you also factor in any mothballed beds that could be brought on steam relatively quickly (this will provide us with a new bed capacity baseline figure). One key assumption here is that all of these additional beds can be safely staffed within your current Board staffing capability.)
(d) From this new total bed capacity we need to understand how many can be utilised for potential C-19 patients. Columns 19-24 asks you to set out your assessment of this.
We also require a short note to be appended to this return highlighting any assumptions you have made in completing the templates and in addition we ask that you identify any additional capacity that may be capable of being brought into use but where staffing is not immediately available. We recognise that there will be further engagement with NHS Boards on the assumptions (including on types of ventilation and isolation) being made locally to complete this initial template.
1 Appendix 1 Can you please note that DCMO has already initiated a piece of work with Boards through an SG Senior Medical Officer to look at the potential to double ICU capacity as per current Pandemic Flu planning assumptions. This is clearly relevant for C-19 therefore your return of the templates should also include your consideration of how quickly that could happen within your Board area.
Please provide your return by 5pm Friday 6 March to [email protected]. If you have queries on the template completion please email the same.
Yours sincerely
JOHN CONNAGHAN CBE Chief Performance Officer, NHSScotland and Director of Delivery and Resilience
2 Appendix 2 Health Performance and Delivery Directorate Chief Performance Officer, NHSScotland and Director of Delivery and Resilience
T: 0131-244 2480 E: [email protected] -
NHS Chief Executives
Copied to Local Authority Chief Executives Chief Officers
___
11 March 2020
Dear Chief Executive
MOBILISATION PLANS
With reference to our discussion at today’s CEO meeting can I now request within one week of the date of this letter your local mobilisation plan preparing for COVID-19.
As a minimum we would expect this plan to show:-
1. How you will scale up ITU and what is the timescale (this should already exist in the responses you have made to John Colvin’s earlier requests).
2. How you will scale up your general bed capacity in line with the return you made last week.
3. What your plans will be to scale back elective inpatients, daycases and outpatients commencing next week and assuming that by the end of March you are capable of scaling back all non-urgent elective treatment but maintaining a full cancer and urgent care service. This should specify numbers by specialty by week.
4. How you are working with partners to reduce Delayed Discharges (how much/by when)
5. How you are planning your entire “whole system” response across Acute/Primary/Social Care. We expect that your local response will reflect the views of local partners and particularly IJBs as they finalise their planning in response to COVID-19. I am copying this note to local authority CEs and IJB officers in the expectation that your Mobilisation Plan will represent a whole system response to what is an unprecedented situation – with implications which will not respect organisational boundaries.
This brief note is not meant to specify all aspects of the content of your Mobilisation Plan – in fact we expect that this may be flexed as we move onto the weeks ahead. However please provide as much detail as possible.
1 Appendix 2
Can you now do two things:-
1. Firstly advise me by next Monday latest on what your “scale down” plans for elective inpatients, daycases and outpatients would look like – before you start to defer these.
2. Send me by COP on Wednesday 18 March your local Mobilisation Plan.
I am aware that in compiling your Mobilisation Plan that this will incur costs such as staff, training, equipment, supplies and bringing mothballed facilities on stream. Please ensure that these are captured with an initial estimate contained in your Mobilisation Plan.
While this letter is geared mainly towards Territorial Boards we also need to see Special Board Mobilisation Plans. Special Boards should consider their own resilience arrangements and how they can support the whole system in providing services during this period. If you need guidance on this your sponsor in Scottish Government can help.
Can I also mention the importance of communication with patients that you may defer for non-ugent and routine treatment to be provided later. Patients should be assured that they will not be forgotten. Their treatment has been deferred until the NHS is capable of providing it. If their condition changes during this (hopefully) brief period of disruption they should contact their GP.
We will seek to finalise your position on your AOP in the next two weeks. This will give us the basis of our Recovery Plan which we can pick up quickly. We should also be aware that there are aspects of the AOP that will not be directly associated with COVID-19. We intend that your local Mobilisation Plan forms an addendum to your AOP for 2020/21.
I am happy to take any queries and look forward to receiving your Plan.
JOHN CONNAGHAN CBE Chief Performance Officer, NHSScotland and Director of Delivery and Resilience
2 SMITH, Diane (NHS ORKNEY)
From: DICKSON, Michael (NHS SHETLAND) Sent: 04 August 2020 10:28 To: DREVER, Christy (NHS ORKNEY) Subject: FW: IMMEDIATE - 2020.03.11 - NHS Chief Executives Business Meeting - Note to Chief Executives in advance of tomorrows meeting
Importance: High
From: [email protected] [mailto:[email protected]] Sent: 10 March 2020 12:13 To: ACE, Jeffrey (NHS DUMFRIES AND GALLOWAY)
1 MUIR, Valerie (NHS FIFE)
Dear Chief Executives
In relation to planning and preparedness for Covid-19 we have commissioned a number of requests over the last week. These include:
what your local Planning and Resilience arrangements are;
how we can upscale primary, secondary and community care capacity, including reducing the number of delayed discharges by 400 within the next few weeks;
doubling the number of ITU beds in the system; and
creating additional acute beds.
Guidance was also issued over the weekend on the management of confirmed Covid-19 cases.
As the Cabinet Secretary is attending our meeting on Wednesday 11 March, I wanted to ask you to come prepared to discuss your response arrangements with us. These discussions will cover what we can do quickly to upscale many initiatives that are already underway, including our digital response to patient care, such as Attend Anywhere and Hospital at Home.
We are experiencing extraordinary pressures that will require us to work differently in order to ensure patient care is maintained across health care services. Working in partnership across the whole system will be essential to deliver this successfully.
Thank you for the work that you and your colleagues have undertaken in response to this. We will continue to support you with the planning and response arrangements throughout these unprecedented times.
Malcolm Wright DG Health and Social Care/Chief Executive NHS Scotland 10 March 2020
SARAH HILDERSLEY Business and Improvement Officer Corporate Business Management Team
2 Office of the Chief Executive NHS Scotland | Health and Social Care Directorates Area 2E(North) | St Andrew's House | Regent Road | Edinburgh | EH1 3DG Tel: 0131 244 2840 E-mail: [email protected]
Working pattern: Tuesday-Friday
<< OLE Object: Picture (Device Independent Bitmap) >>
********************************************************************** This e-mail (and any files or other attachments transmitted with it) is intended solely for the attention of the addressee(s). Unauthorised use, disclosure, storage, copying or distribution of any part of this e-mail is not permitted. If you are not the intended recipient please destroy the email, remove any copies from your system and inform the sender immediately by return. Communications with the Scottish Government may be monitored or recorded in order to secure the effective operation of the system and for other lawful purposes. The views or opinions contained within this e-mail may not necessarily reflect those of the Scottish Government. **********************************************************************
3 Appendix 4 Health Performance and Delivery Directorate Chief Performance Officer, NHSScotland and Director of Delivery and Resilience
T: 0131-244 2480 E: [email protected] -
NHS Chief Executives
___
5 April 2020
Dear colleague
REVISED MOBILISATION PLANS – INFORMATION ON ICU CAPACITY AND ACUTE BED OCCUPANCY
Thank you for all the work you and your teams have undertaken to plan and prepare for COVID19, and for submitting a revised mobilisation plan earlier this week. I wanted to write to you on 2 specific issues.
ICU capacity
In your revised mobilisation plans you set out how you propose to respond to the ask of quadrupling your ICU capacity. I followed this up by teleconference with some of you to better understand the detail of your proposals. In addition, I have also had feedback from Dr John Colvin, Senior Medical Advisor, who has had separate discussions on this with the clinical network. Table 1 plays back to you my view on the maximum surge level you can deliver as a Board and the corresponding picture at a National level.
I would be grateful for your confirmation that your Board can deliver this level of ICU capacity. It would also be helpful if you would intimate any external constraints (eg ventilators or staffing) which would currently inhibit realising this capacity. Finally, can you confirm the increase in this capacity you could deliver in 48 hrs should that be required?
We are currently using Ward Watcher to provide a daily report on current occupancy levels within ICUs. In due course we will use information on future increases in capacity as part of wider public messaging and so it is important that we have captured this data correctly.
Acute Bed Occupancy
The second issue I wanted to mention to you related to plans for reporting of management information on acute bed occupancy. On 1st April, my team started collecting information on ‘empty and occupied acute staffed beds’ from all Boards on a daily basis. We are looking to use this information to report to Ministers, and via them the public, on the position on acute
1 Appendix 4 bed occupancy. Table 2 provides the latest information we have received and compares this to the 2018/19 base line. We know this is a new data series and are grateful to your teams for providing this to us but we also know that there have been some issues about consistent reporting of the data. I wanted to highlight to you the planned use of these data so that you could assist us to ensure the quality and consistency of your Board’s return. I would be grateful therefore if tomorrow’s return (Monday’s) could be checked very carefully.
I would be grateful for a response to my questions on your ICU capacity by 10 am tomorrow if at all possible.
Please get in touch with any questions or queries on this.
Yours sincerely
JOHN CONNAGHAN CBE Chief Performance Officer, NHSScotland and Director of Delivery and Resilience
(enc)
2 Appendix 4
TABLE 1: ICU CAPACITY
NHS Board Baseline Max Surge Ayrshire & Arran 10 40 Borders 5 20 D&G 4 20 Fife 9 36 FVRH 7 28 GJNH 19 38 Grampian 16 86 GGC 40 168 Highland 8 40 Lanarkshire 15 80 Lothian 29 113 Orkney 0 0 Shetland 0 0 Tayside 11 49 Western Isles 0 0 Total 173 718
TABLE 2: ACUTE BED CAPACITY
05 April 2020 2018/19
Published Average Number Health Board of Acute Total Number Total Number Total Number Staffed Published of Empty Acute Occupied Acute of Acute Staffed Beds Occupanc Staffed Beds at Staffed Beds at Beds at Occupancy Available y Midnight Midnight Midnight 05/04/2020 2018/19 2018/19 NHS Ayrshire & Arran 357 390 747 52.2% 952 93.5% NHS Borders 81 82 163 50.3% 225 89.5% NHS Dumfries & Galloway 90 111 201 55.2% 355 89.4% NHS Fife 278 480 758 63.3% 723 86.3% NHS Forth Valley 258 288 546 52.7% 645 88.7% NHS Grampian 354 409 763 53.6% 1,067 82.6% NHS Greater Glasgow & Clyde 1498 1946 3444 56.5% 3,863 87.4% NHS Highland 346 255 601 42.4% 524 89.0% NHS Lanarkshire 507 746 1253 59.5% 1,331 87.4% NHS Lothian 870 1417 2287 62.0% 2,054 90.0% NHS Orkney 48 16 64 25.0% 38 97.6% NHS Shetland 30 14 44 31.8% 43 60.4% NHS Tayside 580 537 1117 48.1% 1,047 78.9% NHS Western Isles 50 16 66 24.2% 70 76.1% National Waiting Times Centre 87 73 160 45.6% 168 78.6% Scotland 5,434 6,780 12,214 55.5% 13,105 87.1%
3 The Balfour Chief Executive Designate Foreland Road Kirkwall Orkney KW15 1NZ www.ohb.scot.nhs.uk
Mr John Connaghan Date: 06 April 2020 Chief Performance Officer NHS Scotland and Director of Delivery and Resilience Tel: 01856 888271 Via email: [email protected] Enquiries to: Iain Stewart Email: [email protected]
Dear Mr Connaghan,
Thank you for your letter of 5 April 2020 regarding the revised mobilisation plans – information on ICU capacity and Acute bed capacity.
I can confirm that table 1 correctly details our status.
Should you require further information on the above please do not hesitate to contact me.
Yours sincerely
Iain Stewart Chief Executive Designate
NHS Orkney Board Headquarters: The Balfour, Foreland Road, Kirkwall, Orkney KW15 1NZ Board Chair: Meghan McEwen Our community, we care, you matter.... Chief Executive: Gerry O’Brien
Orkney NHS Board is the common name of Orkney Health Board Appendix 6 Hea l th Per fo r m ance and Del iv er y Di r ector at e Ch i ef Per fo r m ance Of f ic er , NHSScotl an d and Di r ector o f Del iv er y and Re s i l i enc e
T: 0131-244 2480 E: [email protected] -
NHS Chief Executives
___
9 April 2020
Dear colleague
COVID-19: NHS BOARD MOBILISATION PLANS: ACUTE BED CAPACITY
I am grateful for the rapid turnaround of my request for information on your ICU capacity planning which you provided earlier this week. I now need to make a further request for some specific information on your proposals to maximise acute bed capacity in response to the COVID-19 emergency; and in line with your Board’s mobilisation plan.
This information will enable us to provide Ministers with of an overview of the local plans; and to inform national capacity planning. I attach a template which seeks staffed, acute bed information on an individual site basis, as follows:
1. Your current capacity - this refers to your current capacity as at 00:01 on 10 April, split between COVID and non-COVID, and should align with the information on ‘empty’ and ‘occupied’ acute staffed beds which we collect from Boards on a daily basis. I referred to this in my letter of 5 April.
2. Your maximum surge capacity - the maximum number of acute staffed beds you could provide, split between COVID and non-COVID; consistent with your mobilisation plan. Please note that these beds would have to be in place relatively quickly.
The first column in the template details the latest nationally published information on beds (average available staffed beds, 2018/19). We have used this as the baseline position for national planning purposes; it is linked to explicit Ministerial commitments, i.e. the requirement to re-purpose at least 3,000 of the national total of 13,000 acute beds in response to the emergency; by suspending the normal programme of non-urgent elective activity; addressing as many delayed discharges as possible, etc. We remain clear that vital cancer treatments and emergency, maternity and urgent care will continue.
1 Appendix 6
The template is pre-populated with individual sites derived from Boards’ daily management information returns. Should you have new or additional sites on which you plan to staff and accommodate acute beds, please add and clearly highlight these in your response. The template also provides a notes space to set out any key assumptions which would apply to your proposed maximum surge capacity.
I would be grateful if you could complete the template and return to: Michael Fox, National Improvement Advisor, via: [email protected] by 10:00 on Tuesday, 14 April. If you have any questions about this return, please get in touch with Michael as soon as possible.
Yours sincerely
JOHN CONNAGHAN CBE Chief Performance Officer, NHS Scotland
2