Agenda item

The Select Committee will receive an update from the Clinical Commissioning Group (CCG) on current issues.

Dr Ian Orpen addressed the Select Committee. A copy of the update can be found on their Minute Book and as an online appendix to these minutes, a summary of the update is set out below.

A&E performance

Local system performance appears to have improved in June with 91 per cent of patients seen in A&E within the four hour target wait.  Performance this month (as at 14/07/17) currently stands at 92.6 per cent.  Both the June and July figures do require further validation.

Quarter one review with NHS England

We met with NHS England on 3 July to review our position at the end of the first quarter of 2017/18.This session included  a detailed review of what we are doing in relation to diabetes care and childhood obesity as well as progress on our Financial Recovery Plan.

We have self-assessed ourselves using the CCG Improvement, Assurance & Assessment Framework.  We continue to self- assess ourselves as ‘good’ in two out of the four domains and as ‘requires improvement’ against the ‘Better Care’ area (this reflects current performance issues against a number of NHS Constitution targets) and against ‘Sustainability’ due to the CCG’s financial position. 

New Director of Nursing and Quality announced

We are pleased to announce that Lisa Harvey will be joining us as our new Director of Nursing and Quality after Dawn Clarke left for a new role in Shropshire.  Lisa will officially join us from the 4 September 2017. She is currently working at South Gloucestershire CCG where she has been the Deputy Nurse Director since 2013.

Mental Health Pathway Review

We are working with Bath and North East Somerset Council to carry out a review of community mental health services between May – October 2017.

We will be engaging with a wide range of groups and individuals over the coming weeks, and will use this information, along with other research, to develop a set of models for future community mental health services. As part of our engagement, we have created a survey for those who provide services, people who use services, and those who care for them.

Preferred provider selected for urgent care services across B&NES, Swindon and Wiltshire

Medvivo has been selected to the preferred provider stage of a procurement process to run integrated urgent care services across Bath and North East Somerset (B&NES), Swindon and Wiltshire.  The healthcare provider, which has very recently been rated as ‘Outstanding’ by CQC, will be the lead provider, working in collaboration with Vocare and B&NES Enhanced Medical Services (BEMS+). 

If awarded the contract in the autumn, Medvivo will be responsible for running the NHS111 service across B&NES, Swindon and Wiltshire, developing the service model so callers can be put through to a ‘clinical hub’ of experienced health professionals who can make assessments and advise and arrange urgent care if required. 

In collaboration with Swindon and Wiltshire CCGs and Wiltshire Council we are following a detailed and robust procurement process, with sharp focus on the requirement for innovation and continued development of services. 

School project to raise antibiotic awareness wins national award

A local campaign to raise awareness of the importance of using antibiotics appropriately has won in the Community Engagement category of this year’s national Antibiotic Guardian awards.

The campaign – led by the CCG and B&NES Council with the support of Sirona Care and Health, local public health representatives and national and international science educators – saw Year 3 pupils design posters showing how to wash your hands, catch your sneezes and make sure you take antibiotics properly.

The awards were hosted in London by Antibiotic Guardian, a Public Health England campaign that was set up in 2014 to raise awareness among the general public of the very real threat posed by antimicrobial resistance – resistance to antibiotics.

New ambulance service standards

The new targets will save lives and remove “hidden” and long waits suffered by millions of patients, including reducing lengthy waits for the frail and elderly. The new system is backed by the Association of Ambulance Chief Executives, the Royal College of Emergency Medicine, the Stroke Association and the British Heart Foundation amongst others.

The redesigned system will focus on ensuring patients get rapid life-changing care for conditions such as stroke rather than simply “stopping the clock”. Currently one in four patients who need hospital treatment – more than a million people each year – undergo a “hidden wait” after the existing 8 minute target is met because the vehicle despatched, a bike or a car, cannot transport them to A&E.

Ambulances will now be expected to reach the most seriously ill patients in an average time of seven minutes. The ‘clock’ will only stop when the most appropriate response arrives on scene, rather than the first.

This will free up more vehicles and staff to respond to emergencies. Currently, three or even four vehicles may be sent to the same 999 call to be sure of meeting the 8 minute target, meaning that across the country one in four are stood down before reaching their destination.

The Chair commented that she would like to give some suggestions as to how access and information could be improved at the RUH Accident & Emergency service.

Dr Orpen asked that she email them to him.

Councillor Geoff Ward suggested that additional signage be put in place within the triage area to explain the process.

Councillor Bryan Organ asked what was hoped to be gained by selecting Medvivo as the preferred provider of integrated urgent care services.

Dr Orpen replied that it is intended to provide an improvement of service and bring together the elements of urgent care and the NHS 111 service which are currently separate.

Councillor Tim Ball asked for further information relating to consultation about the urgent care service provision.

Dr Orpen replied that consultation has taken place on the matter and that the Select Committee itself had received previous briefings on the subject. He added that Your Health, Your Voice had taken part in the process and provided feedback.

The Director for Integrated Health & Care Commissioning added that it is not seen as a significant change to the format of the service and that informal engagement has taken place with service user groups.

Councillor Vic Pritchard, Cabinet Member for Adult Care, Health & Wellbeing stated that he was well aware of the process that had taken place so far.

Alex Francis, Team Manager - Healthwatch B&NES and Healthwatch South Gloucestershire commented that further discussions could take place with patients suffering from chronic conditions.

The Chair thanked Dr Orpen for the update on behalf of the Select Committee.