Problems

Increased demand for Christmas and new year holidays, and high absenteeism rates.

Failure of main infrastructure services, preventing staff getting to work.

Shortage of agency staff and 'premium' agency rates.

Loss of key staff to agencies, voluntary organisations and better paid jobs.

Three or fourfold increase in demand for services, plus winter pressures and possible flu epidemic.

Solutions

Consult staff at the earliest opportunity.

Put requests for leave on hold.

Extend the service of staff due to retire, and ask part-timers to work extra hours.

Work with other trusts to avoid competing for staff.

Front load elective work to the first six months of 1999.

Consider nurse/GP-staffed triage centres in known troublespots.

Provide food and sleeping facilities for staff.