Agenda item

The Committee received a presentation from the LLR Health and Care System regarding the plans in place for a resilient winter across the system. A copy of the presentation slides, marked ‘Agenda Item 10’, is filed with these minutes.

 

The Committee welcomed to the meeting for this item Jon Melbourne, Chief Operating Officer, University Hospitals of Leicester NHS Trust, and Rachel Dewar, Assistant Director of Urgent & Emergency Care, Integrated Care Board.

 

Arising from discussions the following points were noted:

 

(i)          There were six national metrics which were being used to measure success:

 

·       111 call abandonment to national standards;

·       Mean 999 call answering times to national standards;

·       Category 2 ambulance response times to national standards;

·       Average hours lost to ambulance handover delays per day to national standards;

·       Adult general and acute type 1 bed occupancy (adjusted for void beds);

·       Percentage of beds occupied by patients who no longer meet the criteria to reside.

 

UHL felt that these were the correct metrics and the ambulance handover metric was the most important. To deliver the national metrics UHL had its own metrics and accountable lead officers for each. The biggest barrier to good performance against the metrics was the workforce challenges. The UHL Trust as a whole had a 12% vacancy rate which in total was 2109 vacancies.  The Emergency Department specifically had a 13% vacancy rate.  Work was ongoing to make UHL a more attractive employer. Work was also taking place with national and regional partners and local universities to create education programmes for health professionals. Bank and Agency staff were used to cover vacancies temporarily. The Locum’s Nest system had just been launched which enabled bank staff to access shifts and ensured they were paid more swiftly.

 

(ii)         The ‘Home First’ approach was being used and recruitment was taking place for this model though there were difficulties recruiting the right numbers and calibre of personnel.

 

(iii)       ‘Virtual wards’ were being used to monitor patients at home such as patients with cardiac problems where their heart rate could be checked remotely.

 

(iv)       The unscheduled care co-ordination hub was a single point of access for people at immediate risk of attending hospital but not seriously ill. It comprised of a home visiting service and ambulance service which prevented people being required to attend the Emergency Department.

 

(v)        Additional acute capacity had been added to the LLR Health and Care System including additional acute beds at UHL, additional community beds and the Ashton residential and nursing care home had been opened.

 

(vi)       Consideration was being given to whether to implement the North Bristol Model of care across UHL. This model involved rapid flow of patients through the hospital and matching the flow to when patients were expected to be discharged.

 

(vii)      It was important that patients were able to access Primary Care to prevent them attending the Emergency Department unnecessarily. The Next Steps for integrating primary care: Fuller Stocktake report had been published which looked at how the implementation of integrated primary care could be accelerated. Consideration was being given to how the recommendations from this report could be implemented in LLR.

 

(viii)    The cost-of-living and fuel / food poverty crisis could have an impact on the Health and Care System over the winter. Concerns were raised that elderly people might not come forward and ask for help. To help tackle these issues the Health and Care System used the ‘Making Every Contact Count’ approach which meant that every interaction a health professional had with a patient was used to support positive changes to the patient’s physical and mental wellbeing. For example if a professional visited a home and noticed it was cold they could make the appropriate referral.

 

(ix)       In response to concerns raised about loneliness it was explained that County Council led initiatives such as Local Area Co-ordinators and Social Prescribing also played a role in tackling this.

 

RESOLVED:

 

(a)        That the plans for a resilient winter across the LLR Health and Care System be noted;

 

(b)        That officers be requested to provide a report for a future meeting regarding Primary Care and the Fuller Stocktake report.