Agenda and minutes

There were no disclosable pecuniary interests.

The minutes of the meeting held on 18^th October 2023 were agreed and signed as a true record.

There were no Matters Arising.

Report of the Chief Operating Officer, UHCW

The Board considered a briefing note of the Scrutiny Co-ordinator and a verbal report and presentation of the Chief Operating Officer, UHCW, which provided an update on the current position of Urgent and Emergency Care (UEC) at UHCW.  The briefing note also provided an update on virtual ward capacity and progress and an update on elective care and the impact of continuing industrial action.

The national target for 4-hour performance within the Emergency Department was 76%.  Year to date, UHCW was performing at 72% in comparison with this.

The Improving Lives Programme was a priority for UHCW and integral to achieving an improved 4-hour performance and improved patient experience.  It was a partnership programme, across Coventry Care Collaborative, which was about fundamentally changing the way we support people in Coventry with urgent need.  It sets out to prevent avoidable hospital attendances and admissions, reduce hospital length of stay and ensure patient discharge as soon as medically fit. 

A number of trials had already evidenced improvement and throughout January the improvements would be rolled out across all hospital wards so that the benefits could be realised for all patients across all specialities.  This would be sponsored by senior leaders further evidencing the commitment of UHCW to achieve improvements for urgent and emergency care pathways. 

In addition, a ‘discharge pull’ model of care would go live, ‘pulling’ patients into community provision as soon as medically fit, as part of the One Coventry Integrated Team model.

However, it was recognised that despite the ongoing improvement work that Improving Lives was delivering, there would be challenges with patient discharges to packages of care over the winter period. 

There were several supportive strategies in place to aid the discharge process with the aim to reduce length of stay, including:

·  Regular escalation meetings.

·  Confirm and challenge weekly with all clinical groups for patients with long length of stay (LLOS) >14 days.

·  Discharge before 12pm and before 5pm weekly meetings to focus on driving early discharges.

·  Quarterly Multi Agency Discharge Event (MADE) meetings.

Ambulance handover performance remained a priority in order to ensure patients were handed over to the Emergency Department within 15 minutes and waited no longer than 30 minutes, thereby releasing paramedic crews to respond to outstanding calls.

In the year to date, 40% of patients had been handed over within 15 minutes compared to a West Midlands average of 36%.  In addition, 80% of patients had been handed over within 30 minutes compared to a West Midlands average of 73%.  During the same time period, 7% of patients waiting in excess of 60 minutes for handover compared to a West Midlands average of 12%.

To support ongoing improvement, in ED there was daily focus and review of ambulance handover times. A regular ‘huddle’ in ED was in place, in conjunction with the HALO, to review daily performance and respond accordingly. This was proving beneficial and would continue over the winter period. 

In addition, Same Day Emergency Care (SDEC) continued to be operational providing  ...  view the full minutes text for item 25.

Report of the Scrutiny Co-ordinator

The Health and Social Care Scrutiny Board (5) noted the work programme.

RESOLVED that the Health and Social Care Scrutiny Board (5) notes the Work Programme with the inclusion of the following:

• Virtual Beds (February 2024) as part of the item on Improving Lives
• NHS Dentistry

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

There were no other items of public business.