National Burns ODN Group A Joint Sub-Committee Action Plan
This presentation accompanies the Specialised Burns SOP for managing surge and escalation in critical care services. It provides guidance on handling referrals, refusals, and mutual aid to manage capacity during periods of increased activity pressure. The document, approved by Major Trauma & Burns CRG and EPRR CRG, outlines levels of escalation for burn services, from normal operation to requiring mutual aid. The National Burns Bed Bureau declares network or national levels of escalation as necessary.
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National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) Management of surge and escalation in critical care services. This presentation is intended as an accompaniment to the Specialised Burns SOP for Surge & Escalation in burns critical care services. It is intended to assist specialised burn services in managing capacity and capability during periods of activity pressure caused by a surge in normal business (BBA Standards [2018] Reference G.10) The document has been approved by: Major Trauma & Burns CRG (December 2019) and EPRR CRG (January 2020) It is important that all members of the Burns MDT, who have some involvement in the process for accepting or refusing referrals, are aware of the SOP and the responsibilities and necessary actions.
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) BURN SERVICE DECLARED LEVELS OF ESCALATION The Burn Service is operating at normal levels and can respond through individual organisational surge plans. The Burn Service is self-declared B-OPEL 1 B-OPEL 1 The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services/networks. The Burn Service is self-declared B-OPEL 2 B-OPEL 2
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) BURN SERVICE DECLARED LEVELS OF ESCALATION The Burn Service is operating at normal levels and can respond through individual organisational surge plans. The Burn Service is self-declared B-OPEL 1 B-OPEL 1 The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 THE BURN SERVICE WILL ONLY SELF DECLARE B-OPEL 1 OR B-OPEL 2
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) BURN SERVICE DECLARED LEVELS OF ESCALATION The Burn Service is operating at normal levels and can respond through individual organisational surge plans. The Burn Service is self-declared B-OPEL 1 B-OPEL 1 The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 THE BURN SERVICE WILL ONLY SELF DECLARE B-OPEL 1 OR B-OPEL 2 THE NATIONAL BURNS BED BUREAU (NBBB) WILL DECLARE NETWORK B-OPEL 3 or NATIONAL B-OPEL 4
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: SOP ACTION CARD REFERENCE BS-4 THE BURN SERVICE WILL UPDATE PATHWAYS DOS TO ACCURATELY REFLECT BEDS AVAILABLE (PART A) AND BED OCCUPANCY (PART D). SOP ACTION CARD REFERENCE BS-6 INFORM THE NATIONAL BURNS BED BUREAU (NBBB) THAT THE SERVICE IS DECLARED AT B-OPEL 2 TELEPHONE NUMBER: 01384 679036.
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL SOP ACTION CARD REFERENCE BS-9 EMERGENCY DEPARTMENT CONTACTS THE BURN SERVICE IN REGARD OF A PATIENT WITH A BURN INJURY. REFERRING ED LOCAL BURN SERVICE
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL SOP ACTION CARD REFERENCE BS-9 EMERGENCY DEPARTMENT CONTACTS THE BURN SERVICE IN REGARD OF A PATIENT WITH A BURN INJURY. THE BURN SERVICE WILL ASSESS THE NEED FOR BURN CARE AND MAKE A DECISION ON WHETHER OR NOT IT CAN ACCEPT THE REFERRAL. THE BURN SERVICE MUST RECORD THE NAME AND CONTACT DETAILS OF THE REFERRING CLINICIAN. REFERRING ED REFERRAL AND ASSESSMENT VIA TRIPS, NORSE or MDSAS TELEREFERRAL LOCAL BURN SERVICE
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED SOP ACTION CARD REFERENCE BS-9 EMERGENCY DEPARTMENT CONTACTS THE BURN SERVICE IN REGARD OF A PATIENT WITH A BURN INJURY. THE BURN SERVICE WILL ASSESS THE NEED FOR BURN CARE AND MAKE A DECISION ON WHETHER OR NOT IT CAN ACCEPT THE REFERRAL. THE BURN SERVICE MUST RECORD THE NAME AND CONTACT DETAILS FOR THE REFERRING CLINICIAN. SOP ACTION CARD REFERENCE BS-11 IF THE BURN SERVICE IS NOT ABLE TO TAKE THE REFERRAL, THE BURN SERVICE WILL CONTACT THE NATIONAL BURNS BED BUREAU (NBBB) 01384 679036 AND ASK FOR HELP WITH MUTUAL AID. REFERRING ED LOCAL BURN SERVICE NBBB 01384 679036 NBBB
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED SOP ACTION CARD REFERENCE BS-9 EMERGENCY DEPARTMENT CONTACTS THE BURN SERVICE IN REGARD OF A PATIENT WITH A BURN INJURY. THE BURN SERVICE WILL ASSESS THE NEED FOR BURN CARE AND MAKE A DECISION ON WHETHER OR NOT IT CAN ACCEPT THE REFERRAL. THE BURN SERVICE MUST RECORD THE NAME AND CONTACT DETAILS FOR THE REFERRING CLINICIAN. SOP ACTION CARD REFERENCE BS-11 IF THE BURN SERVICE IS NOT ABLE TO TAKE THE REFERRAL, THE BURN SERVICE WILL CONTACT THE NATIONAL BURNS BED BUREAU (NBBB) 01384 679036 AND ASK FOR HELP WITH MUTUAL AID. SOP ACTION CARD RFERENCE BS-10 THE BURN SERVICE WILL PROVIDE PATIENT ADVICE AND SUPPORT TO THE REFERRING CLINICIANS. REFERRING ED LOCAL BURN SERVICE NBBB NBBB
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURNS REFERRING ED ALTERNATIVE BURNS SERVICE SERVICE SOP ACTION CARD REFERENCE NBBB-7 SOP ACTION CARD REFERENCE BS-11 NATIONAL BURNS BED BUREAU (NBBB) WILL IDENTIFY A SUITABLE, ALTERNATIVE BURN SERVICE THAT IS ABLE TO TAKE THE REFERRAL, INCLUDING THE CONTACT DETAILS FOR THE RECEIVING HOSPITAL (SENIOR NURSE OR BURNS CONSULTANT). LOCAL BURN SERVICE NBBB NBBB
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURN SERVICE REFERRING ED SOP ACTION CARD REFERENCE NBBB-7 SOP ACTION CARD REFERENCE BS-11 NATIONAL BURNS BED BUREAU (NBBB) WILL IDENTIFY A SUITABLE, ALTERNATIVE BURN SERVICE THAT IS ABLE TO TAKE THE REFERRAL, INCLUDING THE CONTACT DETAILS FOR THE RECEIVING HOSPITAL (SENIOR NURSE OR BURNS CONSULTANT). THE NATIONAL BURNS BED BUREAU (NBBB) WILL CONTACT THE ORIGINAL LOCAL BURN SERVICE AND CONFIRM THE ALTERNATIVE HOSPITAL THAT WILL PROVIDE MUTUAL AID. LOCAL BURN SERVICE NBBB
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURN SERVICE REFERRING ED SOP ACTION CARD REFERENCE NBBB-7 SOP ACTION CARD REFERENCE BS-11 NATIONAL BURNS BED BUREAU (NBBB) WILL IDENTIFY A SUITABLE, ALTERNATIVE BURN SERVICE THAT IS ABLE TO TAKE THE REFERRAL, INCLUDING THE CONTACT DETAILS FOR THE RECEIVING HOSPITAL (SENIOR NURSE OR BURNS CONSULTANT). THE BED BUREAU WILL CONTACT THE ORIGINAL LOCAL BURN SERVICE AND CONFIRM THE ALTERNATIVE HOSPITAL THAT WILL PROVIDE MUTUAL AID. LOCAL BURN SERVICE NBBB IF THE ALTERNATIVE BURN SERVICE IS ACCEPTABLE, THE LOCAL BURN SERVICE WILL PROVIDE THE NATIONAL BURNS BED BUREAU (NBBB) WITH THE NECESSARY CONTACT DETAILS OF THE REFERRING ED CLINICIAN.
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURN SERVICE REFERRING ED SOP ACTION CARD REFERENCE NBBB-7 IF THE ALTERNATIVE BURN SERVICE IS ACCEPTABLE, THE LOCAL BURN SERVICE HAS PROVIDED THE NATIONAL BURNS BED BUREAU (NBBB) WITH THE NECESSARY CONTACT DETAILS OF THE REFERRING ED CLINICIAN. LOCAL BURN SERVICE NBBB
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURN SERVICE REFERRING ED SOP ACTION CARD REFERENCE NBBB-7 IF THE ALTERNATIVE BURN SERVICE IS ACCEPTABLE, THE LOCAL BURN SERVICE HAS PROVIDED THE NATIONAL BURNS BED BUREAU (NBBB) WITH THE NECESSARY CONTACT DETAILS OF THE REFERRING ED CLINICIAN. THE NATIONAL BURNS BED BUREAU (NBBB) WILL MAKE CONTACT WITH THE REFERRING ED CLINICIAN AND PROVIDE THE CONTACT DETAILS OF THE ALTERNATIVE BURN SERVICE. LOCAL BURN SERVICE NBBB
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURN SERVICE REFERRING ED THE REFERRING ED WILL LIAISE WITH THE NEW ALTERNATIVE BURN SERVICE, TO ARRANGE FOR THE PATIENT TO BE TRANSFERRED. LOCAL BURN SERVICE SERVICE LOCAL BURN NBBB
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURN SERVICE REFERRING ED THE REFERRING ED WILL LIAISE WITH THE NEW ALTERNATIVE BURN SERVICE, TO ARRANGE FOR THE PATIENT TO BE TRANSFERRED. THE ALTERNATIVE BURNS SERVICE WILL CONTACT THE NATIONAL BURNS BUREAU (NBBB) AND CONFIRM THAT THE PATIENT HAS ARRIVED SAFELY. LOCAL BURN SERVICE SERVICE LOCAL BURN NBBB
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURN SERVICE REFERRING ED THE REFERRING ED WILL LIAISE WITH THE NEW ALTERNATIVE BURN SERVICE, TO ARRANGE FOR THE PATIENT TO BE TRANSFERRED. THE ALTERNATIVE BURN SERVICE WILL CONTACT THE NATIONAL BURNS BED BUREAU (NBBB) AND CONFIRM THAT THE PATIENT HAS ARRIVED SAFELY. THE NATIONAL BURNS BED BUREAU (NBBB) WILL CONTACT THE LOCAL BURN SERVICE AND CONFIRM THAT THE PATIENT HAS ARRIVED AT THE ALTERNATIVE BURN SERVICE. LOCAL BURN SERVICE SERVICE LOCAL BURN NBBB
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURN SERVICE REFERRING ED IN THE EVENT THAT CIRCUMSTANCES CHANGE AND THE IDENTIFIED ALTERNATIVE BURN SERVICE CANNOT PROVIDE MUTUAL AID, THE ALTERNATIVE BURN SERVICE MUST: RING THE REFERRING ED AND HALT THE TRANSFER LOCAL BURN SERVICE SERVICE LOCAL BURN NBBB
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURN SERVICE REFERRING ED IN THE EVENT THAT CIRCUMSTANCES CHANGE AND THE IDENTIFIED ALTERNATIVE BURN SERVICE CANNOT PROVIDE MUTUAL AID, THE ALTERNATIVE BURN SERVICE MUST: RING THE REFERRING ED AND HALT THE TRANSFER CONTACT THE NBBB AND THEY MUST INFORM THE LOCAL BURN SERVICE LOCAL BURN SERVICE SERVICE LOCAL BURN NBBB
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURN SERVICE REFERRING ED IN THE EVENT THAT CIRCUMSTANCES CHANGE AND THE IDENTIFIED ALTERNATIVE BURN SERVICE CANNOT PROVIDE MUTUAL AID, THE ALTERNATIVE BURN SERVICE MUST: RING THE REFERRING ED AND HALT THE TRANSFER CONTACT THE NBBB AND THEY MUST INFORM THE LOCAL BURN SERVICE SOP ACTION CARD REFERENCE BS-11 THE NBBB WILL BEGIN A SEARCH FOR A NEW ALTERNATIVE BURN SERVICE AND THE PROCESS WILL RESTART (SLIDE 10). LOCAL BURN SERVICE SERVICE LOCAL BURN NBBB
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURN SERVICE REFERRING ED IN THE EVENT THAT CIRCUMSTANCES CHANGE AND THE IDENTIFIED ALTERNATIVE BURN SERVICE CANNOT PROVIDE MUTUAL AID, THE ALTERNATIVE BURN SERVICE MUST: RING THE REFERRING ED AND HALT THE TRANSFER CONTACT THE NBBB AND THEY MUST INFORM THE LOCAL BURN SERVICE SOP ACTION CARD REFERENCE BS-11 THE NBBB WILL BEGIN A SEARCH FOR A NEW ALTERNATIVE BURN SERVICE AND THE PROCESS WILL RESTART (SLIDE 10). LOCAL BURN SERVICE SERVICE LOCAL BURN NBBB SOP ACTION CARD RFERENCE BS-10 THE LOCAL BURN SERVICE WILL CONTINUE TO PROVIDE ADVICE AND SUPPORT TO REFERRING ED, UNTIL A NEW ALTERNATIVE BURN SERVICE IS AGREED AND THE PATIENTS HAS TRANSFERRED.
National Burns ODN Group A joint Sub-Committee of Operational Delivery Networks for Specialised Burns NBODNG - Services Action Plan (Guide to Managing Referrals, Refusals and Mutual Aid) The Burn Service is operating at above normal levels. It is unable to respond through organisational surge levels and MUTUAL AID is required from other burn services. The Burn Service is self-declared B-OPEL 2 B-OPEL 2 ACTIONS: IN THE EVENT OF A NEW REFERRAL BEING REFUSED ALTERNATIVE BURNS SERVICE THE LOCAL BURN SERVICE HAS RESPONSIBILITY FOR SUPPORTING THE TEAM FOR THE PATIENT IN THE NON- BURNS SETTING UNTIL AN ALTERNATIVE SPECIALISED BURN SERVICE IS IDENTIFIED. A RECORD OF THE CASE MUST BE LOGGED BY THE LOCAL BURN SERVICE, INCLUDING: REFERING HOSPITAL AND NAME / CONTACT DETAILS FOR THE PERSON MAKING THE REFERRAL DETAILS OF THE PATIENT AND THE INJURY (TBSA, SII etc) DATE / TIME OF REFERRAL NAME OF THE PERSON REFUSING THE CASE AND REASONS DATE / TIME OF CONTACT WITH THE NATIONAL BURNS BED BUREAU (NBBB) DETAILS OF THE ALTERNATIVE BURN SERVICE ACCEPTING THE PATIENT DATE / TIME PATIENT TRANSFERRED OUT OF ED DATE / TIME PATIENT ARRIVED AT RECEIVING ALTERNATIVE HOSPITAL NBBB
