Agenda item

The Board received a presentation from Adrian Stokes, Coventry and Rugby CCG on the NHS Reset and Recovery Phase 3 Plan and a report of Rachael Danter, Coventry and Warwickshire Health and Care Partnership on the preparation for winter alongside a possible Covid-19 resurgence. Also highlighted was how the system was working together to manage the current and ongoing situation.

The presentation set out the three priorities for the NHS Phase 3 up to March 2021 as follows:

i) Service restoration - accelerate return to near-normal levels of non-Covid health services between now and winter

ii) Prepare for winter demand pressures, alongside probable second Covid surge, locally or nationally

iii) Deliver the above by learning the lessons from the first Covid peak, particularly focusing on support for the staff and inequalities.

Data set out a service restoration progress overview, highlighting levels of activity in September compared to the previous September in the local hospitals. More detailed information was provided on service restoration in respect of cancer and diagnostic services. In relation to referral to treatment times for elective/planned services, which had fallen during the Covid outbreak, service activity meant RTT performance had now started to improve, and the number of patients waiting over 18 weeks had fallen, although there had been an increase in the longest waits of patients over 52 weeks from October. It was expected that these over 52 week waiter numbers would start to fall as elective activity was maintained at current levels. One of the key aspects of the systems response to Covid has been the adoption of new methods of delivering services, such as the development of green Covid free pathways, and the use of technology such as the use of non face to face – virtual appointments using the phone, or video. This meant for a second Covid outbreak, there shouldn’t be the reductions in planned activity to the same scale as in the first Covid outbreak.

In relation to the current Covid position, information was provided on the numbers of Covid patients in the local hospitals since March 2020. Peak numbers at the start of April were over 320 positive patients. At present the numbers in hospital remained relatively low at this time, whilst this remained the case hospitals could continue to press to restore planned care services back to pre-covid levels.

Additional information was provided on the services restoration for primary care and community services and the measures being put in place preparing for the winter and Covid. The presentation concluded with the lessons learnt over the past few months with particular reference to workforce and inequalities.

The report indicated that The NHS remained on a Level 4 incident and associated processes, protocols and levels of preparedness remained in place in all aspects of the system such as Infection Prevention & Control measures, virtual GP appointment capacity, green treatment pathways, independent sector collaboration, close support for the care sector and an effective local Test & Trace programme, including robust Outbreak Management and Local Lockdown Plans. Locally this was being managed through the CCG Incident Control Centre (CICC) supported by a Primary Care Expert Advisory Group (EAG), C&W Care EAG (with a focus on care support) and the Testing Co-ordination Group.

A system wide review of the systems response to Covid-19 had been carried out with all key stakeholders through the Coventry and Warwickshire A&E Delivery Board (CWAEDB) to identify good practice particularly in relation to system wide working, rapid discharge model supporting community services i.e. care homes & domiciliary care providers and mutual aid. This learning was providing the basis of the Coventry and Warwickshire winter preparedness plan to enable patients to access services safely and protect staff whilst preparing for localised Covid19 outbreaks or resurgence.

The report set out the key areas of focus as follows:

·  Expansion of the seasonal flu vaccination programme

·  Expanding the NHS111 first offer

·  Timely and appropriate discharge

·  Supporting care homes

·  Coventry and Warwickshire Communications and Engagement Plan

·  System response and escalation.

The report detailed the activity for each of these areas.

Members raised several issues in response to the report and presentation including a request for information on the current numbers of Covid-19 patients in ICU in Coventry and Warwickshire and, going forward, the proposals for dealing with and supporting patients with long term Covid-19 issues. Clarification was sought about the availability of the flu vaccines and how was the health system going to cope during the winter when Covid and flu symptoms could be so similar. Further information was requested on the hospital discharge strategy for sending Covid-19 patients back to the care home environment and the use of blue beds. Members asked about the priority cohorts for getting the flu vaccination and whether it was intended to use the Nightingale hospital at the NEC in the near future. The importance of communication was highlighted.

RESOLVED that the contents of the presentation and report be noted and the approaches put forward by the Health and Care system on the preparation for winter alongside a possible Covid-19 resurgence be supported.