Agenda item

Briefing Note of Coventry and Rugby System Resilience Group

The following representatives have been invited to the meeting for the consideration of this item:

Sue Davies, Coventry and Rugby Clinical Commissioning Group

David Eltringham, University Hospitals Coventry and Warwickshire

Veronica Ford, Coventry and Warwickshire Partnership Trust

The Scrutiny Board considered a briefing note of the Coventry and Rugby System Resilience Group which provided an update on the current challenges faced within the health economy and the management of these issues. The Board also received a presentation from David Eltringham, University Hospitals Coventry and Warwickshire (UHCW). Sue Davies, Coventry and Rugby CCG, and Veronica Ford, Simon Gilby and Carol Peckham, Coventry and Warwickshire Partnership Trust attended the meeting for the consideration of this item.

The briefing note referred to the delivery of the winter resilience plan and available resources; the recent system challenges and the contribution of the plan to manage these including Delayed Transfers of Care; and the next steps in relation to the Emergency Care Improvement Partnership (ECIP) and transformation programme.

In light of the additional challenges faced during the winter period, an annual winter resilience plan was developed to ensure actions were taken to address these issues. The 2015/16 plan included the following areas of activity aimed at supporting improved performance:

·  Communication, education and engagement

·  Infection control

·  Primary care access, prevention and self-management

·  Providing alternatives to hospitals

·  Hospital flow

·  Supporting discharge.

The Plan also included a continuation of a range of existing initiatives where they were demonstrating success plus some additional new investments. The Board were informed that the total financial resource available for winter resilience for 2015/16 was £2.859m which was a reduction from £3.6m the previous year.

Reference was made to the significant increase in demand for services which meant during the week commencing 25^th January the Trust was unable to admit significant numbers of patients from the Emergency Department. Escalation activity facilitated the discharge of over 300 people over a two day period, with a proportion of the winter resilience fund being used to secure additional social care capacity. Further details were provided on the Delayed Transfers of Care at the hospital.

Further information was set out on how local health and social care was working to deliver sustainable improvement through the development of one improvement plan. The next steps to support improvement were:

·  Piloting an Ambulance Service Accredited Urgent Care Centre taking up to 25 ambulances per day away from UHCW

·  Creating a single point of access to community services for secondary care

·  Running Integrated Neighbourhood Teams at scale with alignment with Frailty and Urgent Primary Care Assessment Centre Pathways to ensure a more seamless step up/ crisis community intervention pathway

·  Developing frailty services across the system so that they work seamlessly and effectively.

The presentation described the system performance for winter 2015/16, provided comment on the success of the winter resilience plan and described improvement activity being progressed across the Health and Social Care system.

The Board questioned the officer and representatives on a number of issues and responses were provided. Matters raised included:

·  Further details about the reduction in Government funding and the funding invested by the Health and Social Care system

·  Learning and new ideas from the three perfect week exercises at the hospital

·  Additional information about the Ambulance Service Accredited Urgent Care Centre

·  Concerns about how the system would be able to cope in future years in light of the increasing demands on the service and the higher numbers of elderly patients

·  What was being done to publicise and try and stop patients attending A and E who didn’t need emergency care

·  Further information about the percentage of patients who shouldn’t be visiting A and E and a concern that GPs were referring patients rather than treating them themselves

·  The potential effectiveness of the transformation programme

·  Were patients attending A and E because they weren’t or couldn’t register with a GP

·  Details about the staff vacancy rates at the hospital and confirmation about total patient capacity

·  The implications of the junior doctors strike

RESOLVED that:

(1) The update on the Winter Resilience Plan and the recent system challenges be noted.

(2) A progress report on winter resilience and the initiatives reported be submitted to a future meeting of the Board in September, 2016.

(3) Briefing notes detailing the following additional information be circulated to all Members of the Board:

(i) A breakdown of the additional funding invested to support measures to improve winter resilience

(ii) Details of the patient capacity at UHCW compared to the numbers of patients treated in the last 12 months and whether there is a capacity gap.