Agenda and minutes

There were no declarations of interest.

The minutes of the meeting held on 23^rd June, 2021 were agreed as a true record. There were no matters arising.

Report of Phil Johns, Coventry and Warwickshire CCGs. Dr Sarah Raistrick, Adrian Stokes and Rose Uwins, Coventry and Warwickshire CCGs have been invited to the meeting for the consideration of this item

The Board considered a report of Phil Johns, Coventry and Warwickshire CCGs and received a presentation from Adrian Stokes, Coventry and Warwickshire CCGs on the restoration of non-Covid services in Coventry. Dr Sarah Raistrick and Rose Uwins, Coventry and Warwickshire CCGs also attended the meeting for the consideration of this item along with Clare Hollingworth, Coventry and Warwickshire Partnership Trust.

The report indicated that in the first half of 2021 there have been two events which had had a significant impact on our restoration of services, firstly, the second wave of Covid cases over December to February, and, secondly, the increasing Covid cases in the last few weeks in June related to the Delta variant.

The system had been selected as a pilot site for NHS England’s “Accelerator” programme which aimed to accelerate the restoration of elective care services. The expectation of this programme was for pilot sites to undertake additional activity and transformation of services so that by the end of July 2021, elective care activity, as measured by value, reached 120% of what it was in July 2019.

To support this pilot, the system had received £10m to support the expansion of capacity to deliver elective care. This was supported by the national Elective Care Recovery Fund (ERF) which provided additional revenue to systems who achieved delivering over 85% of activity levels seen in 2019-20. Associated with this, the system had developed expansion plans for increasing diagnostic activity through community diagnostic hubs.

The Board were informed of the key areas of activity/focus as follows:

i) Recover the maximum elective activity including increasing electives including outpatients to at least 120% of 2019-20 levels by the end of July 2021.

ii) Cancer delivery to restore cancer services including immediate management of 104+ day waits, reducing 62 day and 31 day waits.

iii) Restoration of service delivery in primary care and community services, including backlog of childhood immunisations and cervical screening, programme of structured care home reviews, and all GPs to continue to offer face to face appointments as well as remote triage and video.

iv) Expanding and improving MH/LD services including increasing investment in line with the Mental Health Investment Standard; allocation of funding to core Long Term Plan (LTP) priorities.

v) Preparation for management of any Covid resurgence and preparedness for general increase in emergency activity. In addition, preparing for winter, with activities being detailed in the report.

vi) Reflecting on Covid lessons-learnt and embedding positive change and continuing to support staff, and continued action on inequalities and prevention: a People Plan 2020/21 had been published with some specific objectives to address inequalities.

The report provided an overview of the restoration of services indicating that services were recovering well,  and, as of week of 21st June 2021, the majority of services were at or above the levels from the same period in 2019-20, which was well above the activity seen last year during the first Covid surge. Examples highlighted included almost 1.1million Covid vaccinations being given across Coventry  ...  view the full minutes text for item 9.

Dr Sarah Raistrick, Coventry and Warwickshire CCGs will report at the meeting. Adrian Stokes and Rose Uwins, Coventry and Warwickshire CCGs have also been invited to attend along with Ruth Light, Coventry Healthwatch

Further to Minute 9 above, the Board received a presentation from Dr Sarah Raistrick, Coventry and Warwickshire CCGs on the restoration of GP services. Ruth Light, Coventry Healthwatch attended the meeting for the consideration of this item.

The presentation set out how general practice had responded to the Covid pandemic with a rapid implementation of new ways of working and pathways to support safe care for patients and staff. There had been a wholescale move to ‘total triage’ model across all practices offering patients telephone and video consultations, online consultations and face to face appointments. Practices had worked together with other practices and with other organisations e.g. local hospitals, care homes and the ambulance service and NHS111. There had been an accelerated adoption of technology and the implementation of electronic prescribing. High risk patients who needed to shield were identified and provided with home visiting and prescription deliveries. In addition, core hours were extended, for example GP practices remained open through bank holidays.

The Board were informed about the current position with all practices being open across Coventry offering face to face, telephone and digital appointments. The demand for appointments was back or exceeding pre-Covid levels. The Board noted that 63% of patients were seen on the day or the day after, with 50% of appointments being face to face.

Practices also continued to deliver the vaccination programme, with 78% of all doses being delivered by General Practice.

Members questioned the representatives on a number of issues and responses were provided, matters raised included:

·  Clarification about who was responsible for GP services

·  A suggestion that there should be more opportunities to make on-line GP appointments

·  Concerns about patients being directed to A and E or the walk-in centre due to the unavailability of GP appointments

·  Details about the complaint’s procedures at surgeries

·  Concerns about what happen when a patient doesn’t pick up the call for their telephone appointment

·  Concerns about the availability of GP appointments and the benefits of face to face appointments to enable diagnosis

·  How can Councillors/ residents direct their concerns to Healthwatch 

·  Concerns about limited access to patient data

·  Concerns about access to GP services for patients being discharged from hospital

·  What could be done about an under-performing GP practice.

RESOLVED that:

(1) Content of the presentation noted

(2) Step down care for patients when moving from the hospital back to their home environment to be considered at a future meeting

(3) The report from Healthwatch Coventry on GP access to be circulated to Board members when available.

(4) Details about how to report issues to Healthwatch to be circulated to Board members. 

Report of the Scrutiny Co-ordinator

The Board noted their work programme for the current municipal year.

Any other items of public business which the Chair decides to take as matters of urgency because of the special circumstances involved

The Board were informed of the recent sad death of Edna Eaves. Edna had been an active member of the Patient Panel which was part of the Primary Care Trust. There were no other items of public business.