Agenda item

Presentation

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

Barry Day, Coventry and Warwickshire Partnership Trust

David Eltringham, University Hospitals Coventry and Warwickshire

Steven Jarman-Davies, Coventry and Rugby Clinical Commissioning Group

The Board received a joint presentation on the work of the System Resilience Group on the initiatives being put in place to deal with winter 2016/17 and to achieve the A and E four hour wait. Andrea Green and Steven Jarman-Davies, Coventry and Rugby Clinical Commissioning Group (CCG), Barry Day, Coventry and Warwickshire Partnership Trust (CWPT), and David Eltringham, University Hospitals Coventry and Warwickshire (UHCW) attended the meeting for the consideration of this item. 

The presentation referred to both the NHS National A and E Plan and the Local A and E Delivery Plan. The national focus was on the following five priorities to be delivered locally: streamlining in A and E; NHS 111 calls transferred to clinician; Ambulance Response Programme; improved patient flow; and improved discharge.

The Board were informed about the current performance and system demand around A and E. Performance was below the constitutional standard of 95% of patients having a maximum four hour wait. Local system pressures had been recognised nationally and a more realistic target of 92% had been agreed by the Trust. The Board were informed that following agreement of the local A and E Plan, performance had improved.

Recent demands on the system showed that A and E attendances had risen, short stay emergency admissions were also up, long term emergency admissions were stable while delayed transfer of care (DTOC) remained too high, well above the 3.5% target.

The presentation informed of the system vision and provided a summary of the local A and E delivery plan, which set out the following priorities:

·  Home first – no-one goes to hospital who should be managed elsewhere in the community

·  Avoid – No-one is admitted to hospital that doesn’t have an acute hospital need

·  Pace – Admission through to discharge is effectively co-ordinated and managed to ensure no-one waits more than 24 hours to leave hospital once medically fit for discharge

·  Targeted – On-going care and support resources are targeted at those patients whose needs cannot be met in other ways.

Further information was provided on how these priorities were being delivered along with some examples of the actions in place from the Plan.

The presentation concluded with the governance arrangements. The A and E Delivery Board for Coventry and Rugby was chaired by Andy Hardy, UHCW and included Chief Officer/Director representatives from the partner organisations. The key responsibilities of the Board were detailed.

The Board questioned the representatives and officers present on a number of issues and responses were provided, matters raised included:

·  Support for the initiatives introduced at A and E

·  Additional information about the reasons behind delayed transfers of care

·  Proposals to improve record keeping to allow better tracking of patients

·  Further information about the improvements for dealing with frail patients

·  Proposals for the use of new technology to stream line procedures connected with the patient’s journey through the hospital

·  Proposals for improving the situation relating to the hospital pharmacy and patients’ prescriptions

·  Was the level of resource sufficient to be able to deliver the rehabilitation packages for dementia patients

·  Further information about the constraints around patient discharge when additional support/ care packages were required

·  Additional information about the new Medical Decisions Unit.

RESOLVED that the presentation be noted.