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News from Mr. Williams practice

Mr Williams publishes a plan to make efficiency savings for the NHS during periods of snow and ice

In an article written by Mr Williams and colleagues, “Increased fracture incidence in snow and ice conditions; a model for escalation.” published in the International Journal of Health Planning and Management this month, a proposal on how to deal with a surge of trauma cases during snow and icy conditions is made.

Several studies have shown that the incidence of fractures during periods of snow and ice increases significantly and continues to persist despite preventative measures. The studies discussed in this article suggest that these predominantly consist of “walking wounded” with significant increase in demands in specific services such as the emergency department and the trauma and orthopaedic department. Traditionally, the only formal mechanism in place for most hospitals to react to extreme events is to declare a major incident. This is a binary, all or nothing response, and it is questionable whether an increase of snow and ice‐related fractures would be justified in triggering such an extreme response. On the other end is the “do nothing” approach, which relies heavily on the professionalism, adaptability, and resilience of the staff to deal with the additional demand. The authors present a graded surge plan model for escalation in key resources, such as staff, space, and supplies in order to achieve the most efficient response ensuring good clinical outcome for patients.