Agenda item

Joint report / presentation

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

Simon Gilby, Coventry and Warwickshire Partnership Trust (CWPT)

David Eltringham, University Hospitals Coventry and Warwickshire (UHCW)

Steven Jarman Davies, Coventry and Rugby Clinical Commissioning Group (CCG) 

The board considered a briefing note and received a joint presentation which provided an update on the preparations for winter 2017/18 in order to manage pressures against health and social care including details on the key issues likely to impact on the system. David Eltringham, University Hospitals Coventry and Warwickshire (UHCW), Steven Jarman Davies and Glynis Washington, Coventry and Warwickshire Clinical Commissioning Group (CCG) and Tracey Wrench, Coventry and Warwickshire Partnership Trust (CWPT) attended the meeting for the consideration of this item. Councillor Abbott, Cabinet Member for Adult Services was also in attendance.

The briefing note referred to the requirement for the Coventry and Warwickshire A and E Delivery Board to submit a winter plan to NHS England identifying how the system intended to remain stable and resilient through the winter period. The plan was currently in draft form and would be developed through the Board prior to submission by 1^st December, 2017.

The Board were informed that in many ways pressures experienced at winter continued to be felt beyond the winter period itself with parts of the system remaining under sustained pressure throughout the year, with over 1,000 attendances at A and Es across Coventry and Warwickshire each day and 270-300 patients admitted to hospital each day as emergency patients.

Key priorities to be addressed were:

·  Working to ensure that there was enough capacity across health and social care

·  Ensuring the system delivered care at the most appropriate level for the needs of patients and supporting more people within the community

·  Redesigning the wider Urgent and Emergency Care system

·  Ensuring the system was prepared for dealing with common expected winter illnesses and severe weather events

·  Having an operational resilience network that enacted action plans at peak times through a robust escalation reporting management process.

The briefing note set out the key areas of learning from the previous year.

Reference was made to the key winter plan developments. A set of existing plans were already in place to support resilience over the winter period and further information including existing and additional action plans with delivery dates were set out in an appendix to the briefing note. Key elements to ensure resilience concerned: profiling of elective work and reducing bed occupancy; primary care provision; ambulance response; local authority; UHCW; flu campaign; communication; and system escalation. The plans for each of these areas were detailed.

The Board were informed of the key issues which could have a detrimental impact on the ability to sustain a resilient system which included Christmas and bank holiday demand; workforce capacity; weather and transport; overall risk management; and the Better Care Fund.

The presentation detailed the key priorities to be addressed in winter planning, highlighted the key areas of learning from 2016/17, and detailed the demand for A and E services. The key actions detailed in the winter plan also were set out along with the priorities for UHCW.

Members raised a number of issues in response to the presentation and responses were provided, matters raised included:

·  Clarification as to whether the list of priorities changed each year or remained static

·  Further information on the sharing of good practice and how this could be improved

·  Clarification about the uptake of the flu vaccination by staff in the health sector and what was done to encourage employees to be vaccinated, including stopping the myths surrounding the vaccine, publicity campaigns and if staff had the opportunity to be vaccinated in their work environment e.g. residential homes

·  Support for the Safe and Well service provided by West Midlands Fire Service and information about the partnership working with the Fire Service

·  Whether there were lessons which could be learnt from the winter model at the Queen Elizabeth hospital, Birmingham

·  Further information about nurse staffing redeployment to cover gaps in staffing at UHCW including levels of staffing in wards compared to clinics

·  Details about the percentage of patients attending A and E with minor ailments compared to serious illnesses

·  Information on primary care streaming

·  The impact of Brexit on the recruitment and retention of staff at the hospital

·  Further information about the senior decision makers at A and E

·  Security at the hospital and the support given to the ex-military residents

·  Details about the hospital response to the Chief Inspector of Hospitals, Professor Ted Baker, following his recent letter to all hospital Chief Executives calling for immediate action to improve safety in A and E

·  Further details about the GP provision at A and E and what was being done to refer patients back to their own GPs

·  What was being done to triage residents in social care, particularly the high risk cases, and were additional interventions put in place over the winter months

·  What was being done to manage the delayed transfers of care and were other models being investigated e.g. Northumberland.           

RESOLVED that:

(1) The update on the preparations for winter 2017/18 in order to manage pressures against health and social care be noted.

(2) The continued use of the Safe and Well Service provided by West Midlands Fire Service be endorsed.

(3) An update report on how the health system performed over the winter period be submitted to a future meeting of the Board before the end of the current municipal year.

(4) A report on health care integration be submitted to a future meeting of the Board.

(5) The health authority partners to use the City Councillors as a resource to help ensure that important health messages are delivered to Coventry residents.

(6) The information on the seasonal flu vaccination uptake for Coventry and Warwickshire be circulated to all Board members.