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{"sheet":"Process","index":0,"n_rows":13,"n_cols":2,"rows_kept":13,"cut":false,"hidden":false,"merged":[]}
[]
[null,"Paediatric Daily Sitrep"]
[null,"Data collection process and rationale"]
[null,"Introduction"]
[null,"A paediatric sitrep to sit alongside the existing adult COVID sitrep to provide system wide capacity data across all NHS organisations. The paediatric sitrep is to be collected on a daily basis and used to monitor system pressure and aid decision of provision of mutual aid and system response.\n\nCurrent NHS system is under significant pressure dealing with COVID and COVID recovery and this pressure will become even more acute due to seasonal pressures during the autumn/winter. The existing COVID sitrep only collects data on adult services.\n\nPaediatric services are already starting to experience pressures more acute than at any time during the COVID pandemic. There is a significant rise in the level of demand for services such as eating disorders, CAMHS etc. which are impacting on general paediatric care. Services are also trying to recover from things which were either stopped or delayed in response to the pandemic. It is widely predicted that we will experience an epidemic of paediatric Respiratory Syncytial Virus (RSV). \n\nAn emergency planning desktop exercise highlighted the need for hospital level and system wide data and there are no existing processes which could provide the information required. Equivalent and more extensive data collection is also taking place across the NHS England system and Wales is required to demonstrate it has equally robust oversight to access cross border mutual aid etc.\n\nThis solution is designed to ensure that a defined minimum dataset is collected and submitted on a daily basis to support emergency planning. In summary, the data collection is used to: \n•\tMonitor system wide capacity\n•\tinform service planning and service delivery \n•\tSupport capacity related and mutual aid decisions\n\nAn official letter setting out the mandate for this requirement was issued to Chief Executives on 20th September 2021."]
[null,"Scope"]
[null,"This process encompasses acute paediatric services including general paediatric and critical care units comprising paediatric critical care units/beds (at all levels), special care baby units and neonatal units.\n\nData should be collected and submitted by all health boards that fall within scope, and at site level, i.e. one submission for each site operating paediatric services. Data is to be submitted to DHCW, via the process described below, to collate and forward to Welsh Government and relevant NHS bodies. \n\nBed capacity and occupancy data should be a snapshot as at 10am on date of submission.\n\nAll patients receiving healthcare at the hospital site should be reported regardless of their place of residence."]
[null,"Submission process"]
[null,"Submissions are based on a 10am snapshot position. To enable reporting to Welsh Government the paediatric sitrep data is to be submitted to DHCW by 11am. Note that this is a strict deadline to ensure the data can be processed and extracted for reporting to WG by 12pm. Submissions will therefore be accepted between 10am and 11am.\n\nData is to be collected each day of the week, including weekends, but data collected on Saturdays and Sundays can be submitted on the following Monday.\n\nPilot data submissions were processed from 25th October 2021. Following successful testing of the central process, DHCW are now able to confirm an implementation date of Monday 1st November 2021. All applicable sites should submit data to DHCW from this date onwards.\n\nPlease use the enclosed proforma for data collection, and submit to DHCW in accordance with the process described as follows:\n\n"]
[null,"Open the most recent version of the paeds data template.  If prompted, open as read only and Enable Content."]
[null,"The form is defaulted to Today's date.  If you are submitting data for a previous date or a resubmission of todays data then please select the check box next to the Update Date column."]
[null,"Once you have completed the form please save it locally before submitting it to DHCW via the portal - please use the link below:-"]
[null,"https://forms.office.com/Pages/ResponsePage.aspx?id=uChWuyjjgkCoVkM8ntyPrm78VGNfyJBFu_zxWGTclPxUN0IwMUVPT09KS1JITlkyMlZWWTQ2NkUwMC4u"]

{"sheet":"Definitions","index":1,"n_rows":83,"n_cols":3,"rows_kept":83,"cut":false,"hidden":false,"merged":[[40,2,41,2],[6,2,9,2],[11,2,13,2],[15,2,19,2],[25,2,28,2],[32,2,34,2],[73,2,74,2],[81,2,82,2],[45,2,46,2],[48,2,49,2],[55,2,57,2],[59,2,62,2],[66,2,67,2],[69,2,71,2]]}
[]
[null,"Paediatric Daily Sitrep"]
[null,"Definitions"]
[]
[null,"1. Capacity (based on the type of commissioned bed)","Updated"]
[null,"1.1 Paediatric critical care - commissioned capacity","2021-11-09"]
[null,"The commissioned number of critical care beds, whether vacant, occupied or closed (see below for definition of closed beds).","2021-11-09"]
[null,"Critical care beds are staffed based on the following nurse to child ratios:"]
[null,"• Level 3 - 1:1"]
[null,"• Level 2 - 1:2 "]
[null,"1.2 General acute paediatrics - commissioned capacity","2021-10-28"]
[null,"The number of commissioned general acute paediatric ward and assessment unit beds, whether vacant, occupied or closed (see below for definition of closed beds).","2021-11-04"]
[null,"Ward beds occupied by patients requiring enhanced care are staffed based on the following nurse to child ratio:"]
[null,"• Level 1 – 1:3 or 1:4 dependent on patient mix"]
[null,"1.3 Neonatal - commissioned capacity","2021-11-09"]
[null,"The number of commissioned neonatal care beds, whether vacant, occupied or closed (see below for definition of closed beds).","2021-11-09"]
[null,"Neonatal cots should be staffed based on the following nurse to baby ratios:"]
[null,"• Intensive Care 1:1"]
[null,"• High Dependency 1:2"]
[null,"• Special Care 1:4"]
[]
[null,"2. Occupancy (based on level of care provided)"]
[null,"2.1 Paediatric critical care - Level 3","2021-10-28"]
[null,"Number of beds occupied by patients receiving advanced critical care through invasive ventilation.","2021-10-28"]
[null,"2.2 Paediatric critical care - Level 2 intermediate critical care (HDU level 2)","2021-10-28"]
[null,"Number of beds occupied by patients receiving intermediate critical care through","2021-10-28"]
[null,"• Care of tracheostomy"]
[null,"• Non-invasive ventilation (CPAP/BiPAP)"]
[null,"• Long term ventilation via a tracheostomy"]
[null,"2.3 Paediatric critical care - Temporary Level 2/3 beds outside critical care unit","2021-10-28"]
[null,"Number of beds occupied by patients receiving intermediate/advanced critical care in other settings, e.g. patients intubated in theatre or holding area.","2021-10-28"]
[null,"2.4 Level 1 basic enhanced care (HDU level 1)","2021-10-28"]
[null,"Number of beds occupied by patients receiving basic enhanced care through","2021-10-28"]
[null,"• Oxygen therapy plus continuous pulse oximetry plus ECG monitoring"]
[null,"• Nasal high flow therapy"]
[null,"2.5 General medical/surgical paediatrics","2021-10-28"]
[null,"Number of beds occupied by patients receiving non-critical care treatment on a general medical/surgical paediatric ward.","2021-10-28"]
[null,"2.6 Paediatric assessment unit","2021-11-09"]
[null,"Number of beds occupied by patients receiving non-critical care treatment on a paediatric assessment unit.","2021-11-09"]
[null,"2.7 Neonatal intensive care","2021-10-28"]
[null,"Number of cots occupied by babies receiving intensive care.","2021-10-28"]
[null,"Neonatal intensive care is care provided for babies who are the most unwell or unstable and have the greatest needs in relation to staff skills and staff to patient ratios. This includes any day where a baby receives any form of mechanical respiratory support via a tracheal tube, both non-invasive ventilation (e.g. nasal Continuous Positive Airway Pressure (CPAP), SIPAP, Bilevel Positive Airway Pressure (BIPAP), nasal high flow) AND Parenteral Nutrition (PN), day of surgery (including laser therapy for retinopathy of prematurity (ROP)) and on day of death or any conditions listed as per BAPM categories of care."]
[null,"2.8 Neonatal intensive care stabilisation","2021-11-09"]
[null,"Number of stabilisation cots occupied by babies receiving intensive care as per the definition of neonatal intensive care above.","2021-11-09"]
[null,"2.9 Neonatal high dependency","2021-10-28"]
[null,"Number of cots occupied by babies receiving high dependency care.","2021-10-28"]
[null,"High Dependency care is provided for babies who require skilled staff but where the ratio of nurse to patient is less than intensive care. This care takes place in a neonatal unit where a baby does not fulfil the criteria for intensive care but receives any form of non invasive respiratory support (e.g. nasal, CPAP, SIPAP (infant flow system with multiple modalities), BIPAP, nasal High Flow, parenteral nutrition or continuous treatment of their condition as per BAPM categories of care."]
[null,"2.10 Neonatal special care","2021-10-28"]
[null,"Number of cots occupied by babies receiving special care.","2021-10-28"]
[null,"Special Care is provided for babies who require additional care delivered by the neonatal service but do not require either intensive or high dependency care. It includes babies receiving oxygen via low flow nasal cannula, feeding by nasogastric tube, jejunal tube, or gastrostomy, continuous physiological monitoring, care of stoma, presence of an intra-venous (IV) cannula, receiving phototherapy or special observation or physiological variables at least 4 hourly."]
[]
[null,"3. Additional definitions"]
[null,"3.1 Additional capacity","2021-10-28"]
[null,"The number of additional beds that can be staffed and made available (excluding those reported as part of current capacity). This should change dynamically in line with local response plans, e.g. beds available from 24 hours onwards today that are subsequently made available should move to current capacity.","2021-10-28"]
[null,"3.2 Total potential capacity","2021-10-28"]
[null,"Calculated field:","2021-10-28"]
[null,"(total commissioned beds) + (additional beds that can be staffed from 24 hours onwards)"]
[null,"This denotes the total potential additional capacity available in addition to current capacity. "]
[null,"3.3 Beds occupied by CAMHS, eating disorders and safeguarding patients","2021-11-04"]
[null,"Of the total number of beds occupied, the number occupied by patients requiring additional nursing support for:","2021-11-04"]
[null,"• CAMHS"]
[null,"• Eating disorder"]
[null,"• Safeguarding"]
[null,"3.4 Delayed transfers of care","2021-10-28"]
[null,"The number of delayed transfers of care >4 hours after the reported time fully ready for discharge (or step down to next level of care).","2021-10-28"]
[null,"3.5 Closed and flexed beds","2021-11-09"]
[null,"The number of beds closed or flexed for any reason including staffing. As well as for reporting the number of closed beds, this section should also be used to illustrate where acuity of casemix necessitates changes to the numbers of beds at each level of care from the commissioned baseline, e.g. if a bed is flexed from level 3 to level 2, the number of closed beds at level 3 should be increased, and the number closed at level 2 decreased, even if that means reporting a negative value.","2021-11-09"]
[null,"Note that any paediatric beds occupied by adults should also be reported as closed as these will be reported on the adult sitrep."]
[null,"3.6 Vacant beds","2021-10-28"]
[null,"Calculated field:","2021-11-09"]
[null,"(total commissioned beds) - (total occupied) - (closed beds)"]
[null,"Note that, when beds are flexed from the commissioned baseline, the number of vacant beds may show a negative value, e.g. where a patient requires level 3 care at a site where there are no commissioned level 3 beds, and bed occupancy is therefore greater than the commissioned capacity."]
[null,"3.7 % Occupancy","2021-10-28"]
[null,"Calculated field:","2021-10-28"]
[null,"(total occupied) / [ (total commissioned beds) - (closed beds) ]"]
[null,"3.8 Escalation status","2021-10-28"]
[null,"The escalation status values for the unit/ward, as defined by NHS Wales Operational Pressure Escalation Levels (OPEL). This column should be completed for all relevant rows for the hospital, i.e. if each row constitutes a separate unit, complete for each row, otherwise complete total row. Both the escalation status and staff declaration category should be supplied in the same cell, e.g. 1A, 3.1B, etc. Please see link to OPEL sheet below for details of the applicable values.","2021-10-28"]
[null,"https://nhswales365.sharepoint.com/:b:/s/NWISISDSitrepReporting-Validation/ES-SI8Jw_5JFoV4fsDXuKa0BsHzRBm8p7DBmCBxLx8LHuQ?e=x4FRF9","2021-10-28"]
[null,"3.9 Staff shortfall","2021-11-09"]
[null,"The number of staff short of agreed establishment. This complements the escalation status staffing category with additional details of staffing pressures.","2021-11-09"]
[null,"3.10 Supporting information","2021-10-28"]
[null,"A free text comments box for any further information to support the submission, e.g. reasons for changes in capacity, closed beds, or DToCs, as well as any additional capacity, such as stabilisation cots. Please use this column freely to provide as relevant much information as possible, up to 500 characters.","2021-10-28"]
[null,"Note that supporting information must be supplied when any cell in the relevant row turns red to denote that it requires validation."]

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[]
[]
[]
[null,null,"Health Board",null,null,null,null,null,"V.2.2",null,"Key"]
[null,null,"Hospital",null,null,null,null,null,"updated 25/11/2021",null,null,"To be completed by user"]
[null,null,"Update Date","2021-11-25",null,null,null,null,null,null,null,"Calculated field"]
[null,null,"Update Time","12:43:11",null,null,null,null,null,null,null,"Not applicable or hidden/excluded from initial requirement"]
[null,null,"Updated by",null,null,null,null,null,null,null,null,"Cell dependent on cell above (fill out cell above first)"]
[]
[null,null,null,"Occupancy, capacity and additional bed management information at census time","Occupancy",null,"Capacity - Bed Type",null,null,"Occupancy - Level of Care",null,null,null,null,null,"Additional bed management information",null,"Supporting information"]
[null,"no","Specialty","Description","Respiratory","Non-respiratory","Total commissioned beds","Additional beds that can be staffed from 24 hours onwards","Total potential capacity (current plus surge)","Total occupied","Of total occupied beds - occupied by CAMHS, eating disorder or safeguarding","Of total occupied - occupied by delayed transfers of care","Closed-flexed beds","Vacant beds","% Occupancy","Total staff short of agreed establishment","Escalation status","Please use this column freely to provide any further information to support the submission, e.g. reasons for changes in capacity, closed beds, or DToCs, as well as any additional capacity, such as stabilisation cots"]
[null,1,"Paediatric critical care","Level 3 critical care",null,null,0,0,{"$f":"IFERROR(G12+H12,\"\")","v":0},0,0,0,0,{"$f":"G12-J12-M12","v":0},{"$f":"IFERROR(IF(G12<>0,J12/(G12-M12),\"\"),\"\")","v":""},0]
[null,2,"Paediatric critical care","Level 2 intermediate critical care (HDU level 2)",null,null,0,0,0,0,0,0,0,0,"",0]
[null,3,"Paediatric critical care","Temporary beds",null,null,0,0,{"$f":"IFERROR(G14+H14,\"\")","v":0},0,0,0,0,0,"",0]
[null,4,"Paediatric critical care","Total critical care beds",{"$f":"SUM(E12:E13)","v":0},0,{"$f":"SUM(G12:G14)","v":0},{"$f":"SUM(H12:H14)","v":0},{"$f":"IFERROR(G15+H15,\"\")","v":0},0,0,0,0,0,"",{"$f":"SUM(P12:P14)","v":0}]
[null,5,"Other general acute paediatric","Level 1 basic enhanced care (HDU level 1)",null,null,0,0,0,0,0,0,0,0,"",0]
[null,6,"Other general acute paediatric","General medical/surgical paediatric",null,null,0,0,0,0,0,0,0,0,"",0]
[null,7,"Other general acute paediatric","Specialist ring-fenced beds",null,null,0,0,0,0,0,0,0,0,"",0]
[null,8,"Other general acute paediatric","Paediatric  assessment unit",null,null,0,0,0,0,0,0,0,0,"",0]
[null,9,"Other general acute paediatric","Total general acute beds",{"$f":"SUM(E16:E18)","v":0},0,{"$f":"SUM(G16:G19)","v":0},{"$f":"SUM(H16:H19)","v":0},0,{"$f":"SUM(J16:J19)","v":0},{"$f":"SUM(K16:K19)","v":0},{"$f":"SUM(L16:L19)","v":0},{"$f":"SUM(M16:M19)","v":0},0,"",{"$f":"SUM(P16:P19)","v":0}]
[null,10,"Neonatal","Intensive care",null,null,0,0,0,0,0,0,0,0,"",0]
[null,11,"Neonatal","Intensive care stabilisation cot",null,null,0,0,0,0,0,0,0,0,"",0]
[null,12,"Neonatal","High dependency",null,null,0,0,0,0,0,0,0,0,"",0]
[null,13,"Neonatal","Special care",null,null,0,0,0,0,0,0,0,0,"",0]
[null,14,"Neonatal","Total neonatal care",{"$f":"SUM(E21:E24)","v":0},0,{"$f":"SUM(G21:G24)","v":0},{"$f":"SUM(H21:H24)","v":0},0,{"$f":"IFERROR(SUM(J21:J24),\"\")","v":0},{"$f":"SUM(K21:K24)","v":0},{"$f":"SUM(L21:L24)","v":0},{"$f":"SUM(M21:M24)","v":0},0,"",{"$f":"SUM(P21:P24)","v":0}]
[null,15,"Total","Total critical care, general acute and neonatal",null,null,{"$f":"G15+G20+G25","v":0},{"$f":"H15+H20+H25","v":0},0,{"$f":"J15+J20+J25","v":0},{"$f":"K15+K20+K25","v":0},{"$f":"L15+L20+L25","v":0},{"$f":"M15+M20+M25","v":0},{"$f":"N15+N20+N25","v":0},"",{"$f":"P15+P20+P25","v":0}]
[]
[]
[null,null,null,"data validation",null,null,"value = to or greater than 0 and not blank","value = to or greater than 0 and not blank",null,"value = to or greater than 0 and sum of total occupied and closed beds does not exceed total staffed beds. Cannot be blank","does not exceed total occupied .Value = to or greater than 0 and not blank","value = to or greater than 0 and sum of total occupied and closed beds does not exceed total staffed beds. Cannot be blank",null,null,"value = to or greater than 0 and not blank"]
[null,null,null,"con formatting",null,null,"value = to or greater than 0 and not blank","value = to or greater than 0 and not blank",null,"value = to or greater than 0 and sum of total occupied and closed beds does not exceed total staffed beds. Cannot be blank","does not exceed total occupied .Value = to or greater than 0 and not blank","value = to or greater than 0 and sum of total occupied and closed beds does not exceed total staffed beds. Cannot be blank",null,null,"value = to or greater than 0 and not blank"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,"Health Board","Hospital","Update Date","Update Time","Updated by","resubmit date"]
[null,null,null,null,null,null,null,null,null,null,{"$f":"VLOOKUP(G43,L43:M48,2,FALSE)","v":{"$error":"#N/A"}},{"$f":"VLOOKUP(D5,O43:P61,2,FALSE)","v":{"$error":"#N/A"}},{"$f":"D6","v":"2021-11-25"},{"$f":"D7","v":"12:43:11"},{"$f":"IF(D8=0,\"\",D8)","v":""},false]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,"health board",null,null,"hospital"]
[null,null,null,null,null,null,{"$f":"VLOOKUP(D4,K43:L48,2,FALSE)","v":{"$error":"#N/A"}},null,null,null,"Aneurin Bevan University Health Board","ABUHB","7A6",null,"Nevill Hall Hospital","7A6AM"]
[null,null,null,null,null,null,null,null,null,null,"Betsi Cadwaladr University Health Board","BCUHB","7A1",null,"Royal Gwent Hospital","7A6AR"]
[null,null,null,null,null,null,null,null,null,null,"Cardiff & Vale University Health Board","CVUHB","7A4",null,"The Grange University Hospital","7A6G9"]
[null,null,null,null,null,null,null,null,null,null,"Cwm Taf Morgannwg University Health Board","CTMUHB","7A5",null,"Ysbyty Ystrad Fawr","7A6AV"]
[null,null,null,null,null,null,null,null,null,null,"Hywel Dda University Health Board","HDUHB","7A2",null,"Wrexham Maelor Hospital","7A1A4"]
[null,null,null,null,null,null,null,null,null,null,"Swansea Bay University Health Board","SBUHB","7A3",null,"Ysbyty Glan Clwyd","7A1A1"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Ysbyty Gwynedd","7A1AU"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"University Hospital Llandough","7A4C1"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"University Hospital Of Wales","7A4BV"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Prince Charles Hospital","7A5B3"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Princess Of Wales Hospital","7A3B7"]
[null,null,null,null,null,null,"ABUHB ","BCUHB","CVUHB","CTMUHB","SBUHB","HDUHB",null,null,"The Royal Glamorgan Hospital","7A5B1"]
[null,null,null,null,null,null,"Nevill Hall Hospital","Wrexham Maelor Hospital","University Hospital Llandough","Prince Charles Hospital","Morriston Hospital","Bronglais General Hospital",null,null,"Bronglais General Hospital","7A2AJ"]
[null,null,null,null,null,null,"Royal Gwent Hospital","Ysbyty Glan Clwyd","University Hospital Of Wales","Princess Of Wales Hospital","Neath Port Talbot Hospital","Glangwili General Hospital",null,null,"Glangwili General Hospital","7A2AG"]
[null,null,null,null,null,null,"The Grange University Hospital","Ysbyty Gwynedd",null,"The Royal Glamorgan Hospital","Singleton Hospital","Prince Phillip Hospital",null,null,"Prince Phillip Hospital","7A2AL"]
[null,null,null,null,null,null,"Ysbyty Ystrad Fawr",null,null,null,null,"Withybush General Hospital",null,null,"Withybush General Hospital","7A2BL"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Morriston Hospital","7A3C7"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Neath Port Talbot Hospital","7A3CJ"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Singleton Hospital","7A3C4"]

{"sheet":"Change log","index":3,"n_rows":22,"n_cols":6,"rows_kept":22,"cut":false,"hidden":true,"merged":[]}
[null,null,null,"Feedback summary","Recommendations","Changes applied"]
[1,"Data collection - paediatric critical care"]
[null,"a","Definitions","- Agreement on L3 beds\n- CaV noted that HDU patients are managed on general medical wards for all L1, and for L2 with long-term non-invasive ventilation and with tracheostomy post 1 week insertion\n- HD also noted that new tracheostomies wouldn't be L2, and that nasal high flow therapy does not automatically constitute L1 care\n- CTM suggest applying paediatric-specific levels of care","Review and refine definitions for L2 and L1 based on discussion with stakeholder group","Data collection revised to take HDU L1 out of critical care section and merge with general acute ward beds"]
[null,"b","Occupancy data","Yes, providing that the definitions can be updated, but this is a manual process","As above","As above"]
[null,"c","Capacity data","Yes, providing that the definitions can be updated, but this is a manual process","As above","As above"]
[null,"d","Additional requirements","- SB suggest capturing delayed transfers to critical care, and reporting of patients requiring 1:1 care - CAMHS, safeguarding\n- CaV suggest reporting delayed repatriations","- Add column to capture CAMHS, i.e. of total occupied, how many are CAMHS, etc.\n- Add extra table to capture escalation status and DToC","- Column added to capture number of beds occupied by patients requiring 1:1 care\n- Two new columns added to capture DToC and escalation status information"]
[2,"Data collection - general acute paediatrics"]
[null,"a","Definitions","- CaV suggest separating medical and surgical, and ask whether specialist beds should be included, e.g. renal, cardiac, oncology, etc.","Incorporate specialist beds and include on a separate row as per adult sitrep","Row added to general acute beds section to capture specialist ring-fenced beds separately"]
[null,"b","Occupancy data","Yes, generally captured electronically","None","None"]
[null,"c","Capacity data","Yes, but requires manual collection","None","None"]
[null,"d","Additional requirements","None","None","None"]
[3,"Data collection - neonatal"]
[null,"a","Definitions","Yes","None","None"]
[null,"b","Occupancy data","- Yes, already reported via BadgerNet and Cot Locator\n- HD asked for guidance on reporting for stabilisation cot","Add comments box to capture details of stabilisation cots","Comments column added to the end of the table to allow reporters to supply further information to support their submission"]
[null,"c","Capacity data","Yes","None","None"]
[null,"d","Additional requirements","- SB and CaV suggest accommodating reporting of repatriations","Add facility to capture DToC for neonatal","Column added to capture DToC information"]
[4,"Data submission"]
[null,"a","Method of submission","All 5 respondents reported inability to submit via SQL currently due to data not being captured electronically and stored in local data warehouse","Explore PowerApps as an alternative mechanism for supplying information until this can be incorporated into local data warehouses to support a SQL transfer","TBC pending discussions with DHCW Data Acquisition and Warehouse team"]
[null,"b","Timescales for development","Manual collection could be set up relatively quickly but development resources would be required to set up an electronic process","Start with manual data collection on 18th October","None"]
[null,"c","Submission deadlines","Yes to 2pm deadline, but WG have indicated that this would be required by 1pm to align with COVID sitrep reporting","Change daily submission deadline to 1pm","Submission details updated, with further information to be added following confirmation of process"]
[8,"Additional information"]
[null,null,"Additional requirements","- Weekend reporting arrangements\n- Site vs. health board based reporting\n- Information required for staffing is limited here","Saturday and Sunday to be reported on Monday","- Submission details updated to include instructions for reporting at weekends.\n- Scope section updated to state explicitly that data is to be reported at site level.\n- It is acknowledged that an aggregated data return provides limited information and contains the minimum level of detail required. Further work is being undertaken in parallel to explore opportunities to implement electronic data collection to enable reporting at patient level."]

{"sheet":"Feedback summary","index":4,"n_rows":25,"n_cols":11,"rows_kept":25,"cut":false,"hidden":true,"merged":[]}
[null,null,null,"Summary","Recommendations","Betsi Cadwaladr (BC)","Hywel Dda (HD)","Swansea Bay (SB)","Cardiff and Vale (CaV)","Cwm Taf Morgannwg (CTM)","Aneurin Bevan (AB)"]
[1,"Data collection - paediatric critical care"]
[null,"a","Do you agree with the paediatric critical care data definitions described on the 'definitions' sheet? If not, please describe what you think should change.","- Agreement on L3 beds\n- CaV noted that HDU patients are managed on general medical wards for all L1, and for L2 with long-term non-invasive ventilation and with tracheostomy post 1 week insertion\n- HD also noted that new tracheostomies wouldn't be L2, and that nasal high flow therapy does not automatically constitute L1 care\n- CTM suggest applying paediatric-specific levels of care\n","Review and refine definitions for L2 and L1 based on discussion with stakeholder group","Yes as per same criteria we are using in the NW England","Level 2 HDU care was agreed to be Cpap / Bipap for respiratory patients, not ventilation via tracheostomy and we will deliver care to patients with existing, well established tracheostomy's, not new tracheostomy's. Nasal High Flow therapy, does not automatically constitute Level 1 HDU care. These can be ward based patients with higher acuity. All patients on Oxygen or High flow, would have continuous Saturation monitoring.","We agree that the definitions are correct.","Yes to ICU L3. HDU L2, the following could be cared and are managed on our general medical wards. Care of tracheostomy post 1 week insertion, long term non-invasive ventilation (facial/nasal mask or tracheostomy). All HDU L1 are managed on our general wards","Yes. This data is captured daily on an All Wales basis","Yes. these are taken from the All Wales/BAPM guidance."]
[null,"b","Are you able to provide critical care bed occupancy data as shown in the 'data collection' sheet (F10-G12)? If not, please describe the challenges and what it would take to overcome them.","Yes, providing that the definitions can be updated, but this is a manual process","As above","Yes -Daily reporting currently across BCUHB for Paediatrics and Neonates","Yes.  This will have to be reviewed and populated from manual review of local data.","Yes, daily reporting within Children's services.","Yes, but not in line with the definitions - see above","Yes ","Yes. Daily manual reporting currently in place within the service."]
[null,"c","Are you able to provide critical care bed capacity data as shown in the 'data collection' sheet (J10-K12)? If not, please describe the challenges and what it would take to overcome them.","Yes, providing that the definitions can be updated, but this is a manual process","As above","Yes - Daily reporting currently across Paediatrics and Neonates in BCUHB","yes","Yes, as above.","Yes, but not in line with the definitions - see above","Yes","Yes. Daily manual reporting currently in place within the service."]
[null,"d","Any other comments in relation to data collection for paediatric critical care.","- SB suggest capturing delayed transfers to critical care, and reporting of patients requiring 1:1 care - CAMHS, safeguarding\n- CaV suggest reporting delayed repariations","Add column to capture CAMHS, i.e. of total occupied, how many are CAMHS, etc.\nAdd extra table to capture escalation status and DToC","NA",null,"We would record delays in transfers to a Critical Care unit. Whilst not Level 3 ITU care we need to be able to report patients requiring 1:1 care CAMHS, Safeguarding.","We would like to see something around delayed repatriations as this will impact on our  capacity and what could be staffed in 24 hours ","Staff work on acuity levels 5-1.  The levels of care identified on the spread sheet identify critical care levels. Level 3 being ITU. LEVEL 2 HDU  Levels of care could cause confusion as acuity level of care in Paeds across Wales are:-                                                                                    Level 5 – Waiting for retrieval. Could be CAMHS 1-1 .Continuous observation 24/7. Safeguarding 1-1.\nLevel 4 – (equivalent to level 2 PICU ) Patient highly unstable. Unstable CPAP. DKA. Asthmatic on iv aminophylline. High flow on PPE.\nLevel 3 – Complex care  stable DKA on treatment. Stable patient on iv medication patients on oxygen.\nLevel 2 – Usual paediatric patients admission. Tonsils on IV. Asthmatic on inhalers.\nLevel 1 – period of observation. Patient due to be discharged.\n\nThe acuity and staffing is currently recorded daily at 6pm on the Health Care Monitoring System.\nIn answer to the questions – POWH is unable to care for critical care children on the ward. ITU patients are cared for in ITU or recovery."]
[2,"Data collection - general acute paediatrics"]
[null,"a","Do you agree with the general acute paediatrics data definitions described on the 'definitions' sheet? If not, please describe what you think should change.","- CaV suggest separating medical and surgical, and ask whether specialist beds should be included, e.g. renal, cardiac, oncology, etc.","Incorporate specialist beds and include on a separate row as per adult sitrep","Yes - currently reported daily before 11am as of bed state at 8am","yes","Yes, currently reporting daily before 09.00hrs. However will review times to ensure we capture most activity. SBU content to move times in line with other HB's to have an All Wales position.","We agree however would consideration be given to splitting Medicine and Surgery? And should all paeds be included, e.g. to include renal, cardiac, oncology beds?","Yes ","Yes"]
[null,"b","Are you able to provide general acute bed occupancy data as shown in the 'data collection' sheet (F14-G14)? If not, please describe the challenges and what it would take to overcome them.","Yes, generally captured electronically","None","Yes - from PIMS ","yes","Yes, from Signal.","Yes","Yes, recorded on Healthcare monitoring at 6pm","Yes. Daily manual reporting currently in place within the service."]
[null,"c","Are you able to provide general acute bed capacity data as shown in the 'data collection' sheet (J14-K14)? If not, please describe the challenges and what it would take to overcome them.","Yes, but requires manual collection","None","Yes","yes.  This will have to be reviewed and populated from manual review of local data.","Yes.","Yes","Yes","Yes. Daily manual reporting currently in place within the service."]
[null,"d","Any other comments in relation to data collection for general acute paediatrics.","None","None","NA",null,null,"As above - split between Medicine and Surgery","As above"]
[3,"Data collection - neonatal"]
[null,"a","Do you agree with the neonatal data definitions described on the 'definitions' sheet? If not, please describe what you think should change.","Yes","None","Yes - reported currently as per national guidance","Yes, as per BAPM definitions","Yes, reported x3 daily in line with BAPM standards.","Yes","Yes","Yes"]
[null,"b","Are you able to provide occupancy data for neonatal cots as shown in the 'data collection' sheet (F15-G17)? If not, please describe the challenges and what it would take to overcome them.","- Yes, already reported via BadgerNet and Cot Locator\n- HD asked for guidance on reporting for stabilisation cot","Add comments box to capture details of stabilisation cots","Yes currently reported daily across BCUHB","Yes.  12 cots available.                                                                     Yes. However we do not have any intensive care cots. We have 1 Stabilisation cot which is not included in the cot establishment. Advice needed on how to record the Stabilisation cot. The ability to put N/A if the stabilisation cot is not occupied","Yes, via Cot Locator.","Yes","Badgernet and neonatal network in terms of cot locater ","Data available via Cot Locator"]
[null,"c","Are you able to provide capacity data for neonatal cots as shown in the 'data collection' sheet (J15-K17)? If not, please describe the challenges and what it would take to overcome them.","Yes","None","Yes currently reported daily across BCUHB","The unit is not able to accommodate additional cots due to the environment/layout of the unit.","Yes, as above.","Yes","Yes ","Data available via Cot Locator"]
[null,"d","Any other comments in relation to data collection for neonatal cots.","- SB and CaV suggest accommodating reporting of repatriations","Add facility to capture DToC for neonatal","NA","Should the label for Neonatal  Intensive Care  be \"Intensive Care / Stabilisation ?","Require reporting options for delayed repatriation to other units.","We would like to see something around delayed repatriations as this will impact on our  capacity and what could be staffed in 24 hours ","Neonates – 1 Stabilisation  cot.2 HDU cots.8 special care cots.\nLevels of care are correct Level 1 – ITU. Level 2 HDU Level 3 Special care.\nAcuity is recorded on Bagernet daily . The network pick up activity on the cot locater.\n\n","Could the data be extracted centrally from existing data flows?"]
[4,"Data submission",null,null,null,null,null,null,null," "]
[null,"a","Are you able to submit data to DHCW via SQL to SQL in accordance with the process described on the 'proposals' sheet? If not, please describe the challenges and what it would take to overcome them.","All 5 respondents reported inability to submit via SQL currently due to data not being captured electronically and stored in local data warehouse","Explore Power Apps","Support would be needed for the 3 sites in BCUHB to input this information","We are unable to provide a SQL to SQL submission currently.  Sufficient data is not captured within electronic systems to fully automate the production of the figures.  The patient care level can only be provided by clinical staff on the day.  To provide SQL to SQL there would need to be a development of a template for population by clinical staff that could then be stored electronically and made available via DW technologies however, that would need internal development that would need to be resourced.","We could submit via SQL but the data is not held centrally. The data would be captured manually and provided to the digital intelligence team and loaded into the data warehouse before being submitted electronically.","The data will be provided from an existing manual collection process therefore it will not be available via SQL:SQL - we would like the ability to submit the completed template as we do for other SITREPs.","We could submit via SQL but the challenge is in the collection of the data.  Not all of this data is held in electronic systems and where it is it is often not currently kept in real-time. To provide this via SQL data mart we would need to have the data submitted to the information team first. ","Not all the data is captured within systems with manual input required."]
[null,"b","If development work were to begin today, when would you expect to be able to make your first submission?","Manual collection could be set up relatively quickly but development resources would be required to set up an electronic process","Start with manual data collection on 18th October","Ops Teams would need support from the performance and informatics teams","Development would not be able to begin today due to other developments already in progress or planned.  ","We could submit manually it time for the October submission. Automated submission could take more time.","We are ready to start submissions as per above.","Manual submission could be set up but automated would take more time","Further discussions required with ops team around process."]
[null,"c","Are you able to submit data to DHCW in accordance with the daily submission deadline described on the 'proposals' sheet? If not, please describe the challenges and what it would take to overcome them.","Yes to 2pm deadline, but WG have indicated that this would be required by 1pm to align with COVID sitrep reporting","Change daily submission deadline to 1pm","If systems and process was in place we would be able to report within the timeframe set","yes","Yes.","Yes via the template as above.","Yes ","If systems and process in place."]
[8,"Additional information"]
[null,null,"Please use this row to provide any additional information.","- Weekend reporting arrangements\n- Site vs. health board based reporting\n- Information required for staffing is limited here","Saturday and Sunday to be reported on Monday","Ops teams currently collect data on a shared drive  from the 3 paediatric units. The North Wales Daily Neonatal Unit status is shared via email with the BCU Neonatal daily data group which reports the number of babies and the level of care they are receiving on each site. The number of registered/unregistered nursing staff, shift leaders and their ability to be Supernumerary, it is also noted if there is a likelihood of significant change before the next unit call. The status of each unit is recorded including the states of LWH and APH,  patients with suspected or confirmed cases of Covid 19. Acuity is recorded daily on Badgernet by each unit which calculates the % of shifts staffed to BAPM standards and the average number of nurses on shift / required on shift.   Because the data is not held in a data warehouse we will not be able to submit using SQl to SQL, we would have to email the completed data collection form - please provide details of recipient email","Is weekend reporting required and would that be expected to take place on weekends or on the Monday for the weekend previous.\nIs this submission for RSV patients only ?\nCould the submission be a Health Board submission rather than Hospital based. \nSimilar data is collated for 'Cot Locator' via Neonatal Network - is there some duplication?\nData for this submission would have to be gathered manually as systems will not provide the depth of information required.  ","This does not necessarily give the Qualitative information to support clinical and staffing decisions.","How do we demonstrate the individual risk assessments in situations where due to staffing constraints ITU (1:1) are nursed 2:1? Do we show this as reduced nursed beds, which would then show that there are more babies in the unit than staffed cots. ",null,"Could consideration be give for submission at a different time to COIVD SITREP submission."]
[9,"Respondent details"]
[null,null,"Please provide names and contact details of the main point of contact for paediatric sitrep data submission at your organisation.",null,null,"Jo Douglas interim Operations Manager jo.douglas@wales.nhs.uk ",null,null,"Becci Ingram Becci.Ingram@wales.nhs.uk Karenza Moulton Karenza.Moulton@wales.nhs.uk","Day to day, would be Ward Manager or nominated deputy. There is also a CSG; ILG and Health Board lead for RSV","This requires further discussion with ops team to agree process"]
[null,null,"Please provide the names and job roles of the contributors to this impact assessment.",null,null,"Jo Douglas interim Operations Manager Jessica Jones Operations Manager Christina Billingham Operations Manager Fiona Lewis ","Nick Davies, Service Delivery Manager, Acute Paediatric and Neonatal Services\nBeth Osmukndsen, Snr sister PACU and Paeds OPD\nKaren Jones, Senior Sister\nMichelle Campbell, Business Support Manager Central Operations\nGareth Beynon, Head of Information\nTracy Bucknell, Service Delivery Manager - Community Paediatrics\nCath Jones, Corporate Information Manager",null,"Becci Ingram, Karenza Moulton and Kerry Ashmore","Lisa Jenkins - Children's Ward Manager; Sian Townsend Children's Ward Matron; Lee Evans Clinical Service Manager                                     Rob Jones - Head of Information","Arwel Lloyd - Business Analyst, Luke Wakely F&T Divisional Performance Manager"]