ELECTIVE operations will be curbed from January to March, and knee and hip replacements in the Royal Bournemouth Hospital’s Derwent ward will not take place for eight weeks during this time, the Royal Bournemouth Hospital has announced.

The changes are all part of RBCH’s Winter Plan – which it has been working on since last April – to help tackle the NHS’s seasonal pressures and avoid crisis.

Top of its priorities is achieving a decision to admit or discharge a patient who comes in, within two hours.

“Too many patients wait whilst we as a hospital debate next steps,” said the Winter Plan report. “Getting a service where the right decision is achieved and enacted within the four hours, will be the single greatest measure of our clinical processes.”

The hospital also plans to work with GPs and the South Western Ambulance service to develop swifter specialist admission ‘advice and guidance’ for GPs.

The hospital has already transferred the Fayrewood rehabilitation unit from St Leonards Hospital to RBCH to ease ambulance transfer times, and create a ‘smoother patient pathway’ as part of a national expectation to challenge all hospital stays over 21 days – so-called bed blocking has been cited as a major cause of hospital bed shortages.

“Our ambitious goal is to complete the overall inpatient stay including rehabilitation, within 20 days, and to measurably improve the long term functional levels of patients and return them to their own homes earlier,” said the report. “If achieved, this doubles the effective capacity to the system for bed based care. Careful case management will be crucial.”

However, the hospital has warned that even the way Christmas falls in 2018 could impact the service, saying it was a ‘major risk’ compared to previous years.

“Christmas Eve on a Monday creates a ‘five day weekend’ effect," it said. "Then (there are) two working days and then a four day weekend to January 2nd.”

South Western Ambulance Service has already stopped all leave over this period at all levels, and RBCH says it plans to cease all non-essential activities to focus on urgent care. “This includes not booking elective care unless there is no benefit from stopping,” said the hospital.

The hospital also plans the ‘usual winter step up’ in beds available, including five extra on ward 14 from November, plus extra for the Macmillan Unit. There will also be staff step-up in the clinical site team, housekeeping, portering and transport.

And RBCH will be aiming for a 100 per cent staff vaccination rate against flu, which can decimate the workforce, as well as patients.

The hospital enacts a plan every year and will be similar to those in every other NHS establishment, especially the easing up on elective surgery in the busiest months.