LOGISTICS, RESILIENCE & CONTINGENCY PLANNING a practical example from the Home Oxygen Service
Scotland THE HOME OXYGEN SERVICE
The Basic Need for Oxygen Oxygen is inhaled into the lungs when we breathe, when it reaches the lungs it passes through into the blood stream Carbon dioxide is then passed from the blood back into the lungs to be exhaled as a waste product The blood then carries oxygen around the body to enable each organ to function
Oxygen Therapy Oxygen is a drug 1 Oxygen requires a prescription 1 Oxygen is a treatment for hypoxaemia, not breathlessness Significant hypoxaemia in adults requiring treatment is defined as PaO2 < 8kPa ( SPO2 <92% in room air) 2 Oxygen has no benefit on the sensation of breathlessness in non-hypoxaemic patients 2 1. BMJ Group and Pharmaceutical Press (2011). British National Formulary 61. 2. National Clinical Guideline Centre (2010). Chronic Obstructive Pulmonary Disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care. London: National Clinical Guideline Centre.
What is the Home Oxygen Service? 6500 patients receive domiciliary oxygen supplies in their own home
Families of Oxygen Products Concentrators GOX Oxygen Cylinders LOX Liquid Oxygen
Concentrators
Liquid Oxygen Liquid Oxygen when heated, evaporates. 1 unit of Liquid Oxygen will become 860 units of gaseous Oxygen. LOX boils at -183 c
Oxygen in Cylinders Bulk Filing plant in Stirling 8500 Oxygen Cylinders filled per month 2600 Oxygen Cylinders delivery jobs per month
The Headlines in Scotland Around 6500 patients on Oxygen High profile, NSS reputation for providing a quality service Service operates 24hrs, 365 days a year 600 prescribers / Prescriber s Assistant Annual cost of service is around 6.3m plus electricity costs Electricity cost around 1.1m 300 new patients every month 250 patients pass away every month 70,000 patients interactions per annum
What is a Normal Day in the Home Oxygen Service? 16 customer service team 36 technician on the road 92 inhabited islands 6500 patients 14 Health Boards 11 regional depots 24/7/ 365 service 400 phone calls per day 300 new patients a month Every patient has contingency
Dolby Vivisol BCP Best practice acknowledges that an incident logically flows through three distinct time phases. The Business Continuity Plan is set out in three packs: Red Pack Yellow Pack Green Pack Emergency response to a location-specific incident by the Emergency Controller Tactical or strategic Crisis Management by the Crisis Management Team Operational recovery of the mission critical activities under the leadership of Business Unit Directors / Managers Each colour coded pack flowcharts the delegated tasks and responsibilities of those involved in the three teams. IT disaster recovery is tried and tested annually.
Business Continuity it happens everyday
Issue What can go wrong? Contingency Infrastructure Supply Weather Electricity Fuel Supplies IT Illness / Flu pandemic Island Contingency Event Management Commonwealth Games, European Championships, Brexit Back up facility at Gatwick 6 Months consumables Rain, Snow, Heat Lack of supply Diesel Storage PEN tests Agency staff, flu jabs Fife Storage Alternative plans in place additional oxygen
Beast from the East A practical example
Beast from the East Winter 2018 Winter plans in place Beast from the East Minus 2 days Alert from Scottish Power, Start proactively phoning patients in vulnerable areas Increase stock holding at Depots /Increase filling capacity Winter contingency packs in vehicles Identify areas of UK affected Beast from the East Minus 1 day Due to the active snow fall at 2.00PM All Stirling staff sent home Phone transferred to Gatwick ipscape Contract Manager and Field Service/Ops Director confirmed this decision.
Then this happened!! Full Business Contingency Plans in Place
Day 1 - Wednesday 7am 7.30 9.00 9.30 Conference call Service Delivery team Establish who can get to work Review stock levels / jobs NSS Contract Manager informed. No major issues reported Remote working commenced Scottish Customer Service Planners in Scotland were set up to work from home with back up from Gatwick facility Planners were able to operate from home and techs were kept up to date on emergency job requirements Internal Communication To all staff explaining situation in Scotland with actions Breakdown Service only: no replenishments or any other jobs can be raised Updates Field Engineers, Depot Managers provided updates on availability of staff / techs Planners were cancelling all but urgent jobs in the areas confirmed as affected NSS Contract Manager kept fully updated on the events - Calum walked 2 miles to the office - Filling plant closed as no filling staff could get to work
Day 2 - Thursday Conference call Field and Operations Director held conference call with staff Repeat actions from day 1 7.30 9.00 9.30 Remote working continues Scottish Customer Service Planners in Scotland working from home with back up from Gatwick facility Planners were able to operate from home and techs were kept up to date on emergency job requirements Internal Communication To all staff explaining situation in Scotland with actions Breakdown Service only: no replenishments or any other jobs can be raised Updates Field Engineers, Depot Managers provided updates on availability of staff / techs Planners were cancelling all but urgent jobs in the areas confirmed as affected NSS Contract Manager kept fully updated on the events - Calum walked 2 miles to the office - Filling plant remains closed
Day 3 - Friday Conferenc e call Field and Operations Director held conference call with staff Repeat actions from day 1/2 7.30 9.00 Remote working continues More staff able to make it into Stirling office collected in 4WD Internal Communication Non urgent jobs continued to be rearranged. Many areas now working normally 9.30 Updates Reviewed stock levels as still unable to open filling plant All depots reporting good levels of stock - Gradual improvement in weather - No major issues expected over the weekend
Jobs Completed Thursday to Sunday 01/03/18 to 04/03/18 Phone calls OOH 57 Patient Line 284 Prescriber Line 13 Totals 354 Field Activity Callouts attended 19 Deliveries 187 Installs 33 Removals 14 Services 22 Totals 275