Operation FLOW Updates

Latest Updates

Wednesday 25 September 2024

Today is the final day of our Firebreak ’24 and an incredible amount of planning and fantastic work has been delivered over these past ten days to help reduce occupancy levels across our sites. This not only enables us to deliver the best possible care to the people we serve but also gives a better experience for everybody who works across our whole system.

The hard work, dedication and commitment from everyone doesn’t stop now but thanks to the innovative approach to sustainable changes adopted during this Firebreak, we head into the winter months in a much stronger position.

During Firebreak ‘24, the Chief Executive, the Chair of the Board, several Board members and senior management took the opportunity to visit various wards and departments at our three acute hospitals as well as the FNC+Plus at Kirklands.

Together, they have been consistently impressed by the innovative approaches staff are taking to improve care for our patients.

Firebreak background

The Firebreak initiative focuses on improving safety, quality of care, and staff wellbeing. This vital programme will help create lasting, positive change for everyone across NHS Lanarkshire.

During the Firebreak, we aim to:

Lower occupancy rates in our hospitals
Fewer patients boarding in non-appropriate areas
Improved patient experiences and outcomes
Create a more satisfying work environment for our staff.

Find out more about what Firebreak will achieve, how you can play your part and the sustainable change that teams are working together to deliver. Visit our new Frequently Asked Questions page with all you need to know about Firebreak ’24: Sustainable Change, Safer Care.

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.

Interface Firebreak Frequently Asked Questions

You can learn more about the Flow Navigation Centre Plus (FNC+Plus) – and the broader work of the Interface Directorate – in our FAQ where Trudi Marshall, NHS Lanarkshire’s Interface Director, provides clear answers to key questions.

Together, we are not just addressing the challenges of today but building more resilient services for the future. Your dedication and commitment to this important initiative is crucial to the improvement of our system.

#TeamLanarkshire

Back to menu

Tuesday 24 September 2024

During Firebreak ‘24, Board members have taken the opportunity to visit various wards and departments at our three acute hospitals as well as the FNC+Plus at Kirklands.

Three of our Non-Executive Directors visited University Hospital Monklands on Saturday and met with staff in the Command Centre, Emergency Department and in wards 10 and 17. The Non-Executive Directors learned about discharge planning, including the criteria led discharge pilot, and the experience of the Emergency Department team and they digital system they use.

While at University Hospital Monklands, the Non-Executive Directors recorded a video message for staff and shared their thoughts on Firebreak ’24:

Maureen Lees, Non-Executive Director, said: “I’ve been on walk rounds in several sites over the last week. I’ve been so impressed with what staff have been doing, particularly around patient safety and improving flow through our hospitals to allow people to get the care that they really need.”
Lesley McDonald, Non-Executive Director, said: “I have been truly humbled by the care, compassion and patient centred approach shown by all of the colleagues whom I’ve met with this week. I would like to thank each and every one of them for how they contribute to the patient journey through our hospitals.”
Siobhan White, Non-Executive Director, said: “I’ve been hugely impressed by all the initiatives that staff have been undertaking to improve the service for patients and for staff. Thank you so much to everyone that’s been involved in Operation Flow and the Firebreak week.”

Watch the video message from Lesley, Maureen and Siobhan below.

Firebreak background

The Firebreak initiative focuses on improving safety, quality of care, and staff wellbeing. This vital programme will help create lasting, positive change for everyone across NHS Lanarkshire.

During the Firebreak, we aim to:

Lower occupancy rates in our hospitals
Fewer patients boarding in non-appropriate areas
Improved patient experiences and outcomes
Create a more satisfying work environment for our staff.

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.

Interface Firebreak Frequently Asked Questions

#TeamLanarkshire

Back to menu

Monday 23 September 2024

Senior leaders visited University Hospital Hairmyres to hear about some of the incredible work being done across the site on Friday.

Site Director, Margaret Meek, Chief of Medical Services, Dr Claire McDougall and Chief of Nursing Services, Lise Axford led senior collegues around the Minor Injuries Unit, Emergency Department, Surgical Ambulatory Care Unit and the Frailty Unit.

Within the Frailty Unit, Laura Arthur, Service Manager for Adult and Older People, South Lanarkshire University HSCP, and Eli Begg, Service Manager for Medicine for Older Adults at University Hospital Hairmyres have introduced measures since the start of the Firebreak to reduce length of stay and reduce number of delayed discharges.

This collaboration between acute and social work is already seeing better outcomes with people being discharged without delay by targeting early identification of key pathways. By streamlining the process and identifying patients early, this has resulted in a lot of positive outcomes for patients and means they aren’t in hospital any longer than they need to be.

The 24/72 Discharge Rule has played a vital part in this and has really impacted on the flow for social services and also the flow in the hospital. It has really helped focus everyone on why we need to plan and how we need to plan.

The 24/72 Discharge Rule is being introduced during Firebreak to ensure safe, speedy discharge as close as possible to the Planned Date of Discharge (PDD).

Staff must ensure they are aware of what this means as applying it consistently across all three acute hospital sites will help prevent delays for our patients.

The 24/72 Rule for Requesting Support on Discharge:

Minimum of 24-hours’ notice must be given before PDD for patients who have an existing package of care (restarts)
Minimum of 72-hours’ notice must be given before PDD for patients who need a new referral for supported discharge.

Requests for support on discharge will be triaged by the social work team and, if accepted, directed onto the relevant team for processing.

Multidisciplinary team working during the patient’s stay and the earliest notice possible of requests helps support safe and timely discharge.

The 24/72 rule started on Monday 16 September and continues beyond Firebreak.

Firebreak background

The Firebreak initiative focuses on improving safety, quality of care, and staff wellbeing. This vital programme will help create lasting, positive change for everyone across NHS Lanarkshire.

During the Firebreak, we aim to:

Lower occupancy rates in our hospitals
Fewer patients boarding in non-appropriate areas
Improved patient experiences and outcomes
Create a more satisfying work environment for our staff.

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.

Interface Firebreak Frequently Asked Questions

#TeamLanarkshire

Back to menu

Friday 20 September 2024

Over the past week, the Chief Executive visited various areas with the Chair of the Board and several Board members.

Together, they have been consistently impressed by the innovative approaches staff are taking to improve care for our patients.

Firebreak is a critical time, focusing on making sustainable changes that will strengthen our position heading into the winter months.

A key part of this effort is reducing hospital occupancy, to ensure a better quality of care for our patients and an improved experience for all of us working within the system.

Professor Jann Gardner, NHS Lanarkshire Chief Executive, said: “Thank you for your continued dedication and hard work during this important period. Please keep up the fantastic efforts – your contribution is truly making a difference.”

Watch the full video message below from Professor Jann Gardner, expressing a heartfelt thanks for the exceptional work staff are doing.

Below is a list of the senior leaders who participated and the areas they visited this week:

Michael Breen, Director of Finance and Deputy Chief Executive
Calvin Brown, Director of Communications
Russell Coulthard, Director of Acute Services
Phil Couser, Non-Executive Director
Dr Chris Deighan, Executive Medical Director
Eddie Docherty, Executive Nurse Director
Professor Jann Gardner, Chief Executive
Martin Hill, Board Chair
Jacqui Jones, Director of HR
Colin Lauder, Director of Planning, Property and Performance and Deputy Chief Executive
Colin Lee, Non-Executive Director
Maureen Lees, Non-Executive Director
Councillor Eileen Logan, Non-Executive Director
Trudi Marshall, Interface Director
Lesley McDonald, Non-Executive Director
Professor Ross McGuffie, Chief Officer, University Health & Social Care North Lanarkshire
Brian Moore, Non-Executive Director
Stephen Peebles, Deputy Director of Acute Services
Professor S Josephine Pravinkumar, Director of Public Health and Health Policy
Sylvia Stewart, Non-Executive Director and Employee Director
Siobhan Whyte, Non-Executive Director
Donald Wilson, Director of Digital Services

Kirklands HQ

FNC + Plus

University Hospital Hairmyres

Ambulatory Care
Frailty Unit
Minor Injury Unit

University Hospital Monklands

Command Centre
Medical Assessment Unit
Minor Injury Unit
Safety Huddle
Ward 17 (Saturday) – respiratory medicine; discharge planning, criteria led discharge pilot

University Hospital Wishaw

Minors
Orthopaedic/Trauma Assessment Unit
Safety Huddle
Surgical/Surgical Ambulatory Care Unit

Thank you to those who took part and to those who made the visits possible.

Firebreak background

The Firebreak initiative focuses on improving safety, quality of care, and staff wellbeing. This vital programme will help create lasting, positive change for everyone across NHS Lanarkshire.

During the Firebreak, we aim to:

Lower occupancy rates in our hospitals
Fewer patients boarding in non-appropriate areas
Improved patient experiences and outcomes
Create a more satisfying work environment for our staff.

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.

Interface Firebreak Frequently Asked Questions

#TeamLanarkshire

Back to menu

Thursday 19 September 2024

Today Dr Chris Deighan, the Executive Medical Director talks about the aims of Firebreak 24. He emphasisies that the main aim of firebreak is to reduce occupancy levels across all of our sites.

He said: “If we manage to reduce occupancy levels, then we will improve patient care, we will reduce boarding across our hospitals, and we will improve the experience that staff see on a daily basis when going about their jobs.

“The changes that we are trying to achieve we are aiming for these to be sustainable going forward, and we would welcome all staff’s input into these changes and encourage staff to be involved with Firebank 24 going forward.”

Watch the full video message below from Dr Chris Deighan, NHS Lanarkshire Executive Medical Director.

Firebreak background

The Firebreak initiative focuses on improving safety, quality of care, and staff wellbeing. This vital programme will help create lasting, positive change for everyone across NHS Lanarkshire.

During the Firebreak, we aim to:

Lower occupancy rates in our hospitals
Fewer patients boarding in non-appropriate areas
Improved patient experiences and outcomes
Create a more satisfying work environment for our staff.

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.

Interface Firebreak Frequently Asked Questions

#TeamLanarkshire

Back to menu

Wednesday 18 September 2024

Yesterday, our Chair and Chief Executive visited University Hospital Wishaw, University Hospital Monklands and the Flow Navigation Centre (FNC+Plus) to hear about all the incredible work taking place in teams across these sites to enable us to deliver the best possible care to the people we serve.

The Chair and Chief Executive were joined on the visits by Phillip Couser and Siobhan White, two of NHS Lanarkshire’s Non-Executive Directors.

Watch a short video below from Martin Hill, Chair of NHS Lanarkshire.

In the video, Martin speaks about how impressed he was with the positivity and creativity of our staff and acknowledges how hard everyone is working. On behalf of the Board, the Chair also thanks all staff for making patients’ lives better.

While visiting University Hospital Monklands, the group saw the Planned Investigation Unit and the Surgical Ambulatory Care Unit (SACU). They met staff and heard about how both units are enhancing the patient experience and reducing the time patients have to stay in hospital.

At University Hospital Wishaw, Site Director, Claire Ritchie, Deputy Site Director, Graham Simpson and Chief of Medical Services, Dr Ken Dagg gave the group a tour of the Minor injury Unit (MIU), Orthopaedic and Trauma Assessment Unit (TAU), Surgical Ambulatory Care Unit (SACU) and ward seven Acute Medicine and Respiratory where they heard about all the work taking place.

Firebreak background

The Firebreak initiative focuses on improving safety, quality of care, and staff wellbeing. This vital programme will help create lasting, positive change for everyone across NHS Lanarkshire.

During the Firebreak, we aim to:

Lower occupancy rates in our hospitals
Fewer patients boarding in non-appropriate areas
Improved patient experiences and outcomes
Create a more satisfying work environment for our staff.

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.

Interface Firebreak Frequently Asked Questions

#TeamLanarkshire

Back to menu

Tuesday 17 September 2024

As Firebreak entered day 2, NHS Lanarkshire’s senior leaders visited a number of different departments across University Hospital Wishaw, University Hospital Monklands and the Flow Navigation Centre (FNC+Plus) to hear about all the incredible work taking place in teams across these sites to enable us to deliver the best possible care to the people we serve.

Watch a short video below from Dr Ken Dagg, Chief of Medical Services at University Hospital Wishaw.

In the video Ken talks about the importance of the board rounds and huddles in our continuing care wards. There has been a big emphasis on Planned Date of Discharge (PDD) and the 24/72 hour rule.

The 24/72 Rule is being introduced during Firebreak to ensure safe, speedy discharge as close as possible to the Planned Date of Discharge (PDD).

Staff must ensure they are aware of what this means as applying it consistently across all three acute hospital sites will help prevent delays for our patients.

The 24/72 Rule for Requesting Support on Discharge:

Minimum of 24-hours’ notice must be given before PDD for patients who have an existing package of care (restarts)
Minimum of 72-hours’ notice must be given before PDD for patients who need a new referral for supported discharge.

Requests for support on discharge will be triaged by the social work team and, if accepted, directed onto the relevant team for processing.

Multidisciplinary team working during the patient’s stay and the earliest notice possible of requests helps support safe and timely discharge.

The 24/72 rule started on Monday 16 September and continue beyond Firebreak.

Firebreak background

The Firebreak initiative focuses on improving safety, quality of care, and staff wellbeing. This vital programme will help create lasting, positive change for everyone across NHS Lanarkshire.

During the Firebreak, we aim to:

Lower occupancy rates in our hospitals
Fewer patients boarding in non-appropriate areas
Improved patient experiences and outcomes
Create a more satisfying work environment for our staff.

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.

Interface Firebreak Frequently Asked Questions

#TeamLanarkshire

Back to menu

Monday 16 September 2024

As Firebreak goes live, the wider Interface Directorate will have an active role in supporting Team Lanarkshire’s broader aims.

Senior team members from the Interface Directorate have been assigned to collaborate intensively with colleagues across the health and care system. One of the main objectives is to help staff understand the new Directorate’s values, the core systems in place, and how they operate. Most importantly, the team will emphasise why the work of the Interface Directorate is essential.

NHS Lanarkshire’s senior leaders have visited the Flow Navigation Centre Plus (FNC+Plus). It’s the nerve centre of the Interface Directorate’s ongoing efforts to support coordinated, advanced, and timely care to patients during some of the most vulnerable moments of their lives.

You too can learn more about FNC+Plus – and the broader work of the Directorate – in our Pulse story with FAQs. Trudi Marshall, NHS Lanarkshire’s Interface Director, provides clear answers to key questions.

Firebreak background

The Firebreak initiative focuses on improving safety, quality of care, and staff wellbeing. This vital programme will help create lasting, positive change for everyone across NHS Lanarkshire.

During the Firebreak, we aim to:

Lower occupancy rates in our hospitals
Fewer patients boarding in non-appropriate areas
Improved patient experiences and outcomes
Create a more satisfying work environment for our staff.

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.

#TeamLanarkshire

Back to menu

Friday 13 September 2024

Our Firebreak ’24, will start on Monday 16 running through to Wednesday 25 September 2024.

Thank you for the incredible amount of planning work that has taken place in your teams and across the whole organisation. There is so much drive and ambition shown by our staff to improve our services so that we can deliver the best possible care to the people we serve.

Watch a short video below from Eddie Docherty, Director for Nurses, Midwives and the Allied Health Professions.

Eddie Docherty, Director for Nurses, Midwives and the Allied Health Professions is encouraging all staff to work together. Those individuals who deliver direct patient will make the difference as we go into the Firebreak.

Just as importantly, we need to improve patient care and safety, maintain patient confidence and the patient experience but also make sure you, as staff members, are safe and can work effectively together. Eddie firmly believes we can all make a difference.

24/72 Rule for Requesting Support on Discharge

The 24/72 Rule is being introduced during Firebreak to ensure safe, speedy discharge as close as possible to the Planned Date of Discharge (PDD).

Staff must ensure they are aware of what this means as applying it consistently across all three acute hospital sites will help prevent delays for our patients.

The 24/72 Rule for Requesting Support on Discharge:

Minimum of 24-hours’ notice must be given before PDD for patients who have an existing package of care (restarts)
Minimum of 72-hours’ notice must be given before PDD for patients who need a new referral for supported discharge.

Requests for support on discharge will be triaged by the social work team and, if accepted, directed onto the relevant team for processing.

Multidisciplinary team working during the patient’s stay and the earliest notice possible of requests helps support safe and timely discharge.

The 24/72 rule will start on Monday 16 September and continue beyond Firebreak.

UHW rolls out the Optimal Discharge Target Operating Model (TOM)

University Hospital Wishaw has launched the new Optimal Discharge Planning Target Operating Model (TOM), which aims to streamline the patient discharge process and improve overall patient experience.

The hospital-wide rollout follows months of planning and stakeholder collaboration. Clinical staff and staff from social care attended a workshop earlier this week to ensure the new model is fully embedded – visit our Pulse page to read more.

New Frequently Asked Questions (FAQ)

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.

#Team Lanarkshire

Back to menu

Friday 6 September 2024

There is just over one week to go to our Firebreak ’24, which will take place from Monday 16 to Wednesday 25 September 2024.

An incredible amount of work is being undertaken across our whole organisation, with new projects and developments across all our sites to improve our services to deliver the best possible care to the people we serve.

Watch a short video from Russell Coulthard, Acute Director below.

Russell Coulthard, our Director of Acute Services, encourages all staff to play an active role in supporting Firebreak particularly given our dedication to enhancing our services and creating a better work environment for all our staff. He highlights we’re all on a journey towards sustainable improvement.

Russell explains what success will look like:

Lower occupancy rates in our hospitals
Fewer patients boarding in non-appropriate areas
Improved patient experiences and outcomes
A more satisfying work environment for our staff.

Success – Home First

As we continue to implement the Optimal Discharge Target Operating Model (TOM) across all our sites, it’s important to share positive examples of compassionate care. This week a warm-hearted story that demonstrates our ‘Home First’ ethos and the important role our Care at Home staff play in helping to deliver this was shared.

Visit our news page to read a love story that has burned for over six decades and continues to shine brightly thanks the compassion of dedicated home carers.

Home First means that people can be cared for at home (or as close to home as possible) and aims to prevent unnecessary hospital admissions. If someone does need to come into hospital, the goal is to get them back home or into a community setting as soon as possible.

To learn more about the implementation of the Optimal Discharge TOM all staff are encouraged to watch the new Optimal Discharge video that explains the key components of the model below.

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions.
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.

#Team Lanarkshire

Back to menu

Friday 30 August 2024

Just over two weeks to go to our Firebreak ’24 taking place during 16-25 September 2024.

Preparation is well underway across our whole organisation with new projects and developments across all our sites to improve our services to deliver the best possible care to the people we serve. As we continue to transform and reform our services there is a lot of outstanding work that is being delivered throughout our whole system.

We need all staff to play an active role in supporting Firebreak. Please discuss in your teams and with your manager if you need more information.

Success – Home Assessment Team

This week our Health and Social Care North Lanarkshire colleagues were in the spotlight with a visit from the Cabinet Secretary for Health and Social Care to learn about the Home Assessment Team. Neil Gray MSP visited Wishaw’s Houldsworth Centre to find out more about the innovative service changing how people in North Lanarkshire recover in their own homes rather than staying in hospital.

A number of the partnership’s staff were also on hand to share the successes of other programmes designed to help patients leave hospital so that they can remain part of their communities.

Staff told the Health Secretary how they have dramatically cut the number of people whose discharges are being delayed through programmes such as the Wishaw Enabling Hub work, Operation Flow and the Discharge Without Delay and Planned Date of Discharge initiatives. The Home Assessment Team will play an important role in supporting the Firebreak.

The team carries out an ongoing assessment of each person’s specific needs in their home with wrap-around support for up to two weeks and often sees them within hours of their discharge from hospital. Neil Gray also thanked the staff involved in this short video below. To read more visit our news page.

Sustainable change

In order to deliver sustainable change a number of key projects are continuing to develop and more information will be provided over the next few weeks:

Diagnostic Virtual Step Down: Aiming to maximise the numbers of patients who are clinically stable whilst awaiting an investigation e.g. CT scan to go home via our newly developed Diagnostic H@H and wait safely in their own home for their investigation with clear processes in place should their condition deteriorate or worsen.
Call Before You Convey (FNC+Plus): Aiming to refine emergency response strategies to ensure our patients are being cared for in the right place whether that be in a community or hospital setting. Our teams are working with many of the paramedics in SAS to improve their understanding of the new developments with our FNC Plus team.
Direct Assessment Pathway (Frailty): Focusing on streamlining admissions for frail patients with strong partnership working SAS as well as collaboration between SAS, GPs, FNC+ Plus and specialties to facilitate direct or scheduled admissions to a specialty ward for GP heralded patients in UHH site.

Optimal Discharge Planning Target Operating Model: A collaborative effort to enhance and embed good discharge planning processes. Our new video supports our newly implemented Optimal Discharge Planning Target Operating Model (TOM) now in place. This has been designed to improve patient discharge experiences across all hospitals in Lanarkshire. If you haven’t already, please make sure you watch the new video below.

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.

#Team Lanarkshire

Back to menu

Friday 23 August 2024

In the weeks leading up to our Firebreak ’24 – taking place during 16-25 September – there is a lot of preparation underway throughout our organisation with every part of our system working together. This includes NHS Lanarkshire, our Health and Social Care Partnerships in North and South as well as with the Scottish Ambulance Service.

Today, we are rolling out a new video to support our newly implemented Optimal Discharge Planning Target Operating Model (TOM) now in place. This has been designed to improve patient discharge experiences across all hospitals in Lanarkshire. This model will play a crucial role in ensuring that our patients have a smooth and well-coordinated transition from hospital to home or other care settings, avoiding unnecessary delays and improving overall outcomes.

It is essential that all staff involved in the discharge process are familiar with it the Optimal Discharge Planning TOM.

Here are three actions that you can take to ensure you can play your role in further embedding the Optimal Discharge Planning Target Operating Model:

Watch the new Optimal Discharge video
To help you embed this new approach, we encourage all staff to watch the introductory video that explains the key components of the model and attend one of our events that is happening across our sites (details below).

The video highlights the following:

Discharge Pathways: The model introduces four pathways to identify and address the specific discharge needs of each patient, ensuring that every step is tailored to their situation.
Multidisciplinary Team (MDT) Approach: The model emphasises the importance of early and continuous discharge planning involving the entire MDT, ensuring all patients receive the right care at the right time.
Key Principles: Effective discharge planning involves early patient and family engagement, detailed assessments, and proactive arrangements to ensure a seamless discharge process.
Patient-Centred Care: Our goal is to make every discharge a positive experience for our patients, supporting their recovery and reducing their time in hospital.

The video will also guide you through the roles and responsibilities within the MDT and the activities that ensure timely and safe discharges.

We encourage you to take the time to watch this important video and familiarise yourself with the new model. By working together and applying these principles, we can enhance patient care, reduce hospital occupancy, and create capacity for new admissions.

Thank you for your continued commitment to providing the best care for our patients.

2. Attend a team briefing session about our new Optimal Discharge Target Operating Model

There are many briefing sessions take place across the organisation so please take the time to attend one.

- University Hospital Monklands event – running today – Friday, 23 August 1400-1600, lecture theatre
- University Hospital Wishaw – Thursday 29 August 09.30-11.30, lecture theatre
- University Hospital Hairmyres – w/c 2nd September date tbc
- HSCP North and South – date tbc

3. Complete the new Turas module on Optimal Discharge
Click here to complete the new module – https://learn.nes.nhs.scot/74427

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.
Find Out More: Visit our webpages to find out more about Operation FLOW: www.nhslanarkshire.scot.nhs.uk/OperationFLOW/

#Team Lanarkshire

Back to menu

Friday 16 August 2024

Your commitment and effort are crucial as we strive to improve our services and deliver the best possible care to the people we serve.

As an organisation, we are committed to enhancing our services and making NHS Lanarkshire a better place to work. We understand that change can be challenging, and I want to express my deep appreciation for your willingness to join us on this journey.

Over the past 12 months, we have been working diligently to create the conditions necessary for sustainable change. We have seen many examples of innovation and commitment along the way as we work to transform and reform our system.

Looking ahead, here’s what success will look like:

Lower occupancy rates in our hospitals
Fewer patients boarding in non-appropriate areas
Improved patient experiences and outcomes
A more satisfying work environment for our staff.

For our staff, this means you will be better equipped to do your job, ensuring the right patients are in the right place at the right time, within an environment that is more rewarding to work in.

Achieving this will require commitment from every member of our team. I encourage you to take the time to review the updates, discuss new pathways and technologies with your teams, and actively participate in making these improvements.

If you have any suggestions that you believe could make a difference, please share them with us.

Our objective is to unite Team Lanarkshire to make these changes a reality. Together, we can make it happen. #Team Lanarkshire

The next stage of our improvement journey is a new Operation FLOW firebreak to accelerate our transformation efforts and achieve lasting improvements in patient care and acute hospital flow.

Firebreak ’24: Sustainable Change, Safer Care will take place from 16 – 25 September 2024.

It marks another significant step on our journey to work collaboratively across the whole health and care system in Lanarkshire improve flow and deliver benefits for both patients and staff.

We know more is required to make the sustainable improvements we need to deliver the best care we can.

I am asking for you to show leadership at all levels and take the opportunity of Firebreak ’24 to give us a solid platform from which to build before the busy winter period.

This briefing sets out our initial plans for Firebreak ’24. We will keep you updated as these develop and with more details on each of the actions planned.

Please get involved: read this briefing; discuss in your teams; make sure you know what you can do to help; and let us know your ideas and feedback. #Team Lanarkshire

Objectives

Reducing occupancy levels in our hospitals plays a crucial role in the safe and effective operation of our hospitals. Firebreak ’24 will be focused on significantly reducing occupancy levels through:

Managing Unscheduled Care Demand: Enhancing our response systems and pathways to better manage demand.
Implementing the Front Door Target Operating Model (TOM): Streamlining patient admissions to improve initial care processes.
Maximizing Flow Through Optimal Discharge Planning: Applying consistency across our patient discharge planning processes.
Fostering Sustainable Changes for Improved Safety: Implementing long-term safety improvements.
Launching Transformational Initiatives: Setting the stage for ongoing enhancements in our healthcare services.

Key Principles

Our actions during the Firebreak period will adhere to principles that ensure our efforts are both effective and sustainable:

Simplicity and Sustainability: Implementing straightforward, lasting changes.
Collective Leadership and Accountability: Shared leadership at all levels to guide and support our initiatives.
Focus on Launching New, Sustainable Workflows: Introducing practical and beneficial ways of working.
Enhancing Staff Morale and Ease of Work: Making our work environment more efficient and supportive.
Measurability of Impactful Changes: Ensuring changes lead to measurable improvements.

Proposed Actions and Leadership

To successfully implement these changes, we have outlined several key actions including:

Call Before You Convey (FNC+Plus): Aiming to refine emergency response strategies.
Direct Admission Pathway (Frailty): Focusing on streamlining admissions for frail patients.
Optimal Discharge Planning Target Operating Model: A collaborative effort to enhance discharge processes.
Communication and Engagement Plan: Ensuring we keep all staff, GPs and the public informed and engaged.

Feedback and Engagement

We highly value your feedback and encourage you to actively participate in shaping Firebreak ’24:

Feedback Channels: Please use our dedicated email address operationFLOW@lanarkshire.scot.nhs.uk to share your thoughts, suggestions and questions
Stay Engaged: Discuss in your teams and stay updated through our weekly internal communications.

Back to menu

Operation FLOW 2 Updates

Wednesday 31 January 2024

Thank you for everyone’s hard work during the short, targeted firebreak to help improve flow across our acute sites following the festive period.

I’m very proud of our staff and the service improvements that we’ve made over the weeks before, during and after the festive period. I know how hard you and your teams are working throughout the winter months to support colleagues and care for all our patients.

Since we launched Operation FLOW nearly a year ago, our #TeamLanarkshire approach is making a positive difference to our whole-system. The energy and resilience shown by our staff has helped to improve relationships and communication across all our health and social care teams.

The system improvements are enabling better patient flow and also a reduction in both our occupancy levels and length of stay of our patients in our hospitals sites.

As we continue to address our winter pressures, we have more senior staff supporting decision making on our wards as well as a marked increase in the use of our discharge lounges in our acute sites.

As part of Operation FLOW, we are continuing to make positive changes and improvements for the better. Over the next few weeks, over 30 new staff will join our teams including new roles focussing on patient flow to help continue to drive down our occupancy levels.

While there will be challenges ahead, we know we will continue to work together as Team Lanarkshire to address them. It’s also important to take the time to acknowledge our successes so far.

Thank you for your continued support. #TeamLanarkshire

Questions, comments or ideas can be sent to the project team by emailing: operationFLOW@lanarkshire.scot.nhs.uk

Back to menu

Friday 5 January 2024

A whole-system firebreak will take place from Monday 8 January to help improve flow across our acute sites following the festive period.

As throughout Operation FLOW, the following will be crucial during the firebreak:

Reducing our occupancy, even by a relatively small amount, can make a huge difference to our patients and staff.
Every member of Team Lanarkshire has a part to play. Teams are working hard to further embed the Flow Foundation Bundle to improve patient flow and prevent unnecessary waiting for patients.
Reducing the length of stay of patients is crucial to help us address our occupancy levels. A particular focus continues on patients whose length of stay is 14+ days with clear plans in place to support their journey.

There will be a whole-system focus from services to support enhanced flow during the week beginning 8 January. The acute hospitals and health and social care partnerships have drawn up firebreak plans with the range of actions across our acute sites and the community including:

Increased Hospital @ Home capacity to reduce admission where appropriate
Use of Hospital Assessment Team and Home First to support earlier discharges
Length of stay reviews of patients to support discharge planning
Increased use of discharge lounge
Additional on-call support
Scottish Ambulance Service to make full use of Flow Navigation Centre to access to alternative pathways and advice
Enhanced medical cover and additional nursing staff
Senior staff supported Board Rounds

In addition, non-essential meetings are being stood down from 3 to 19 January where this is necessary to free up senior staff to support flow.

Thank you for your continued support. #TeamLanarkshire

Our Operation FLOW webpages have been updated to provide staff with easier access to key information from the Operation FLOW Playbook such as the Flow Foundation Bundle. The website will continue to be developed and can be viewed at: www.nhslanarkshire.scot.nhs.uk/OperationFLOW .

Questions, comments or ideas can be sent to the project team by emailing: operationFLOW@lanarkshire.scot.nhs.uk

Back to menu

Friday 22 December 2023

A whole system-system firebreak will take place from Monday 8 January to help improve flow across our acute sites following the festive period.

As throughout Operation FLOW, the following will be crucial during the firebreak:

Reducing our occupancy – even by a relatively small amount – can make a huge difference to our patients and staff.
Every member of Team Lanarkshire has a part to play. Teams are working hard to further embed the Flow Foundation Bundle to improve patient flow and prevent unnecessary waiting for patients.
Reducing the length of stay of patients is crucial to help us address our occupancy levels. A particular focus continues on patients whose length of stay is 14+ days with clear plans in place to support their journey.

Increased Hospital @ Home capacity to reduce admission where appropriate
Use of Hospital Assessment Team and Home First to support earlier discharges
Length of stay reviews of patients to support discharge planning
Increased use of discharge lounge
Additional on-call support
Scottish Ambulance Service to make full use of Flow Navigation Centre to access to alternative pathways and advice
Enhanced medical cover and additional nursing staff
Senior staff supported Board Rounds

In addition, non-essential meetings are being stood down from 3 to 19 January where this is necessary to free up senior staff to support flow.

Thank you for your continued support. #TeamLanarkshire

For more information about Operation FLOW, you can watch the following presentation by Judith Park, Director of Acute Services, which was recorded at a recent staff roadshow: https://vimeo.com/nhslanarkshire/operationflow

In addition, our Operation FLOW webpages have been updated to provide staff with easier access to key information from the Operation FLOW Playbook such as the Flow Foundation Bundle. The website will continue to be developed in the new year and can be viewed at: www.nhslanarkshire.scot.nhs.uk/OperationFLOW .

Questions, comments or ideas can be sent to the project team by emailing: operationFLOW@lanarkshire.scot.nhs.uk

Back to menu

Operation FLOW 2 – FIREBREAK: Insights and Next Steps

Thursday, 7 December 2023

The recent targeted firebreak across our whole-system made a positive difference to our drive to reduce bed occupancy and enable improved flow across the acute sites in preparation for winter.

The key points from the firebreak remain crucial as we enter the winter period:

Reducing our occupancy – even by a relatively small amount – can make a huge difference to our patients and staff.
Every member of Team Lanarkshire has a part to play. Teams are working hard to further embed the Flow Foundation Bundle to improve patient flow and prevent unnecessary waiting for patients.
Reducing the length of stay of patients is crucial to help us address our occupancy levels. A particular focus continues on patients whose length of stay is 14+ days with clear plans in place to support their journey.

One of the key benefits of the firebreak was as a learning tool to help us better understand and refine the actions that make the biggest difference, so we can effectively target further Operation FLOW developments and firebreaks.

An exercise to capture the lessons learned from the firebreak has been competed to provide an overview of the system wide learning with, along with the learning from the acute sites, and North and South health and social care partnerships.

The firebreak approach involved two primary strategies: a system-wide review of inpatients with a stay exceeding 14 days and site-based improvement actions aimed at increasing discharges and reducing occupancy levels.

Our review process looked across both acute and community sites, focusing on patients with extended lengths of stay. We identified actions to enhance discharge planning and encountered various challenges, including the need for more explicit documentation and training on palliative care referral processes.

Each site provided valuable feedback, revealing the effectiveness of initiatives like Criteria Led Discharge (CLD) and frailty pathways. This feedback also highlighted the necessity for more robust discharge planning and reducing duplication of processes.

There was a promising shift in crucial performance metrics:

A slight improvement in NHS Lanarkshire’s 4-hour compliance
A significant reduction in patients waiting over 12 hours
Stable occupancy levels with notable improvements at some sites.

Further work is now taking place on how to best embed the learning from the November firebreak and to agree the timing and details of the next firebreak. We will keep you updated on this work.

Thank you for your continued support. #TeamLanarkshire

We are current redeveloping our Operation FLOW webpages and will relaunch soon to give easier access information and resources for staff: www.nhslanarkshire.scot.nhs.uk/OperationFLOW .

Questions, comments or ideas can be sent to the project team by emailing: operationFLOW@lanarkshire.scot.nhs.uk

Back to menu

Operation FLOW 2 – FIREBREAK: Reducing occupancy ahead of winter

Friday 24 November 2023

Thank you for everyone’s hard work this week on the short, targeted firebreak across our whole-system – community and acute sites. This has made a positive difference to our whole-system drive to reduce bed occupancy to enable improved flow across the acute sites in preparedness for winter. Well done #TeamLanarkshire!

We will share more details about the outcomes of the firebreak and the next steps next week.

The key points from the firebreak remain crucial as we enter the winter period:

Reducing our occupancy – even by a relatively small amount – can make a huge difference to our patients and staff.
Every member of Team Lanarkshire has a part to play. Teams are working hard to further embed the Flow Foundation Bundle to improve patient flow and prevent unnecessary waiting for patients.
Reducing the length of stay of patients is crucial to help us address our occupancy levels. A particular focus continues on patients whose length of stay is 14+ days with clear plans in place to support their journey.

Thank you for your support. #TeamLanarkshire

Questions, comments or ideas can also be sent to the project team by emailing: operationFLOW@lanarkshire.scot.nhs.uk

Back to menu

Operation FLOW 2 – FIREBREAK: Reducing occupancy ahead of winter

Monday, 20 November 2023

This week will see the start of a short, targeted firebreak across the whole-system – community and acute sites. This will involve a whole-system drive to reduce bed occupancy to enable improved flow across the acute sites in preparedness for winter.

Some key points to note:

Reducing our occupancy – even by a relatively small amount – can make a huge difference to our patients and staff.
Every member of Team Lanarkshire has a part to play. Teams will be working hard to further embed the Flow Foundation Bundle to improve patient flow and prevent unnecessary waiting for patients.
Reducing the length of stay of patients is crucial to help us address our occupancy levels. A particular focus will be on patients whose length of stay is 14+ days with clear plans in place to support their journey.

Thank you for your support. #TeamLanarkshire

Questions, comments or ideas can also be sent to the project team by emailing: operationFLOW@lanarkshire.scot.nhs.uk

Back to menu

Contact Us

If you have ideas, comments or questions for the project team, email us at operationFLOW@lanarkshire.scot.nhs.uk

Back to menu