ALISTAIR RENNIE CONSULTANT IN EMERGENCY MEDICINE MANCHESTER UNIVERSITY NHS FOUNDATION TRUST
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1 1 ALISTAIR RENNIE CONSULTANT IN EMERGENCY MEDICINE MANCHESTER UNIVERSITY NHS FOUNDATION TRUST
2 2 A QUIET PLEA FOR THE NEXT 30 MINUTES OR SO: Please don t tweet No photos please Keep it in the room Be aware, some of this may be upsetting
3 3 CONFLICT OF INTERESTS Consultant in Emergency Medicine (MRI, RMCH) Lead for Adult Major Trauma (MRI ED) Trust Lead for EPPR (MFT) MERIT Doctor (NWAS) BASICS (Basics NW) Pre-Hospital Care (NWAA)
4 GLOBAL REPUTATION 4
5 MANCHESTER 5
6 6
7 7
8 Was it inevitable? 13/11/ /03/ /07/ /03/ /12/2016
9 9 EARLY 2016 Post Birmingham meeting Greater Manchester reconfiguration (update to GM EPRR plan) GM Health & Social Care Partnership EPRR meetings NWAS needs Major Incident exercise (Elsa/ Socrates)
10 EPRR PATIENT DISPERSAL FRAMEWORK 10
11 EPRR GM CASUALTY CAPABILITY CHART
12 One night in May - Pop Start Princess 12
13 13
14 14
15 15
16 16
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19 19
20 20 A GM TIMELINE Time of 1st call 22:32 22:46 All live Major Incident Declared casualties cleared from scene 02:46 05:25 Major Incident stood down
21 21 NWAS ON-SCENE RESOURCE Number of resources by type: Paramedic Ambulances 60 RRV 8 APs/CPs 6 Doctors 5 at scene 1 in area command HART 3 teams (2 NWAS teams + EMAS in to Manchester for support) Total staff 300
22 22 CASUALTY DISPERSAL Trauma NWAS Total attended Hosp name status (from scene) hospital RIP (ED) Admissions Critical care MTC MRI (CMFT) MTC (P) RMCH (CMFT) (5 Ad) MTC SRFT MTC UHSM TU ROH 7 14 (4 Ch) - 6 (2 Ch) - TU SHH 6 11 (2 Ch) - 7 (1 Ch) 3 TU WWL LEH NMGH 5 17 (3 Ch) LEH TGH - 7 (3 Ch) LEH RBH 8 17 (6 Ch) - 8 (2 Ch) 1 LEH FGH Totals
23 CASUALTY DISPERSAL 23
24 24 CMFT RESPONSE MAJOR INCIDENT DECLARED GMP MAJOR INCIDENT DECLARED NWAS WHATSAPP ALERT TO ED TEAM. DEPARTMENTS CLEARED TO RECEIVE PATIENTS
25 25 BEWARE CURRENT PATIENTS
26 26 HOWEVER CLEAR THE DECKS PED - GMP 8F P1 + MUM P3 AND DAD P3 SEEN BY DUTY CONSULTANT LEADING MT TEAM - SHRAPNEL F GMP BOLT THROUGH NECK X P3 OWN TRANSPORT LEG WOUNDS
27 INJURIES CAUSED BY SHRAPNEL
28 28 WHOLE BODY CT FOR ALL
29 29
30 MRI CONSULTANTS DURING NIGHT OF 22/23 MAY Emergency Department 8 Orthopaedics 4 General Surgery 2 Vascular Surgery 3 CT Surgery 4 Anaesthetics 11 ICU 9 Radiology (+IR) 4 Burns and Plastics (USHM) 1 Multiple middle grades all specialities
31 RMCH CONSULTANTS DURING NIGHT OF 22/23 MAY Emergency Department 4 Paediatric Orthopaedics 4 Burns and Plastics 4+ Paediatric Neurosurgery 4+ Paediatric ENT 4 Paediatric Surgery 5 Paediatric Anaesthetics 11 Paediatric Radiology 1 + Paediatrician support 2 CAMHS support Multiple middle grades all specialities
32 32 CAPACITY CMFT 13 adult ICU beds cleared 10 PICU beds cleared (8 across northern network) 2 NWTS transfers to Alder Hey 4 Adult Theatres running o/n 4 Peads Theatres running o/n Network 23 Theatres running o/n MRI closed to Trauma for 1/7 RMCH closed to Trauma for 7/7 Plastics closed to Trauma for 10/7
33 A VERY LONG TAIL 33
34 34 SERVICE IMPACT 22 additional trauma lists over first 10 days 6 in first 18 hours 58 operations in the adult cohort 90 hours of operating 5 patients in critical care for 12 days 38 elective cases rescheduled for surgery 150 out patient appointments re-scheduled Cost to the organisation in lost income from displaced activities, additional costs in excess of 2.4 million
35 Bereavement Care & Support Overview SWAN Model implemented for all 22 families 20 families attended Trafford Mortuary 2 families contacted & supported in a different way Collaborative cross boundary working 24/7 helpline & triage system implemented First 72hrs families supported by the bereavement team 24/7 All 22 families have a named bereavement nurse for follow up care
36 BEWARE 36
37 THE GEOGRAPHY CHALLENGE 37
38 SECURITY 38
39 THE PRESS 39
40 BLOODY VIP S 40
41 UNKNOWNS 41
42 42 INSTITUTIONAL LEARNING COMMUNICATION POST ACUTE PHASE POST INCIDENT DOCUMENTATION NEEDS TO BE STANDARDISED (NETWORK OR NATIONAL LEVEL) HANDOVER OF PATIENT LOCATION RECORDS OF AVAILABLE EQUIPMENT/LOCATION SUSTAINABILITY CONSISTENCY OF SURGICAL MANAGEMENT CONSIDER DIFFERING SURGICAL TEAM REQUIREMENTS KEEPING FAMILIES TOGETHER CAMHS PLAN CLINICAL LEADS JUNIOR SUPPORT SOCIAL MEDIA MEDIA AND CELEBRITY VISITS NEED A DEDICATED MANAGEMENT STREAM
43 LIFE CONTINUES 43
44 GMR 44
45 A CITY RECOVERS 45
46 46 FOR THE FUTURE Closer Working With Networks Understanding Your Neighbouring Network s Dispersal Plan & Specialty Matrix Better Definition Of Roles Gold Command Vs. Network Clarity Over Official Figures Need Better Protocols For Data Collection / Sharing Pro Forma Nominated Data People In Trusts NHS Passports Cruciform Triage Card Tracking Supplies (Ex-fix, Theatre Sets, Wheelchairs) Role Of Enhanced Care Teams
47 @DrDaleview 47
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