Presentation from Adrian Stokes, Coventry and Rugby Clinical Commissioning Group (CCG)
Minutes:
The Board received a presentation from Adrian Stokes, Coventry and Rugby CCG which provided on update on Covid-19 – Restoration, Recovery and Reset. Laura Crowne, University Hospitals Coventry and Warwickshire (UHCW) provided detailed examples of the ongoing work at the hospital with particular reference to cancer and endoscopy and the current situation at the Emergency Department. Dominic Sands, Coventry and Warwickshire Partnership Trust provided an update on the current work concerning mental health at the Trust in light of covid-19.
The presentation provided a brief summary of the current context, the governance arrangements and the takeaway messages as outlined at the last Place Forum meeting. The context to restoration, recovery and reset was set against the ongoing backdrop of Covid-19 with attention being drawn to the strengthening of partnership working over the past few months and the importance of locking in innovation that had been implemented during this time. The current governance arrangements for Coventry and Warwickshire were set out and included reference to the Kings Fund model. The takeaway messages had been: that all four phases would happen simultaneously; the level 4 response would be running into the winter which could coincide with a second wave as well as the usual winter pressures; the partnership working was a real positive and avoided duplication; and communication was key.
Phase 2 priorities were: essential services; mental health; test, track and trace; and care homes.
In relation to cancer actions, reference was made to the daily management of scheduling, with a dedicated management team for risk management. Operation and clinical governance assisted the clear escalation structure. Further information was provided on the operational planning to optimise the utilisation of available NHS and IS capacity.
Data detailed waiting list numbers and the numbers of patients treated for the different cancers along with the diagnostic scanning numbers at BMI. In relation to endoscopy, the Board were informed of the current position which included a 50% capacity due to IPC regulations. All 2ww patients were being managed effectively within timescales however the backlog for routine and surveillance was growing. The daily management of actions, the current position and challenges for the whole team were highlighted.
The current position and risk relating to managing emergency demand was detailed. The next steps for this area included having Task and Finish Groups on direct access pathways; engagement in NHS111 plans and linked DOS as part of winter plans to direct patients away from Emergency Departments; continued working on mental health pathways with partners; continued engagement on discharge work; and effective winter planning.
The presentation referred to the strategic drivers of demand for services provided by CWPT which included the impact of lockdown and social isolation; the economy (recession and unemployment); traumas; and long term conditions. The groups most likely to be impacted were highlighted along with the physical, mental and community health implications. The Board were informed of the mental health priorities in light of covid-19 which were:
· Collaborative working and agreements across the sector
· Improved integration between primary care and specialist mental health services
· Children and young people
· Improving urgent and emergency healthcare
· Reduction in out of area placements
· Rapidly evaluate service changes made during covid-19 to understand long term implications
· Psychological support to NHS staff.
The presentation concluded with the next steps as follows: strong infection prevention measures to enable restart; full winter response including Nightingale usage; and the continued use of the independent sector. It was acknowledged that partnership working was critical.
Members sought clarification about the levels of cancer referrals and whether the system had the capacity to test everyone.
The Chair, Councillor Caan thanked the partners for the presentation and for all the work being undertaken by their organisations.
RESOLVED that the contents of the presentation be noted.