Agenda item

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

Corinne Edwards addressed the Select Committee, a summary of the update is set out below.

Working with Practice Participation Groups

All 27 GP practices in B&NES are required to have a Patient Participation Group (PPG). These groups work in partnership with their practices to help patients take more responsibility for their health; contribute to the continuous improvement of services and quality of care; foster improved communication between the practice and its patients; and provide practical support for the practice to implement change.

The CCG organised a joint meeting for all PPGs on 14 March which attracted 16 PPG representatives.  The event was well received with the PPGs learning from each other and sharing best practice.  The PPG reps asked for the CCG to support them with creating Terms of Reference and providing training for new members a few times a year.

Update on A&E performance

Between the months of March to December 2015, an average 89.3% of patients were seen in A&E at the Royal United Hospitals Bath NHS Foundation Trust (RUH) within four hours. 

In January this percentage dropped to 76% (against a national target of 95%) and the RUH was one of 30 hospitals in England identified with the worst A&E waiting times for that month. The hospital continues to perform highly on quality aspects of A&E services. It remains one of the top performing trusts in the region in ensuring a swift handover between ambulance and A&E staff. This means patients arriving by ambulance are brought in quickly and ambulance crews are freed up to respond to 999 calls.

The System Resilience Group (SRG) continues to oversee implementation of a four-hour recovery plan to strengthen urgent care performance and ensure patients receive the highest quality care.

On 24^th March we held an Urgent Care Summit with clinical leads from a number of key providers. Participants reviewed emergency admissions data and the range of services currently available and explored what we can do differently in order to reduce the growth in emergency admissions seen during 2015/16 without impacting adversely on patient experience.

Planning for 2016/17

We are developing our plans and priorities for next year to ensure high quality care and improve the health and wellbeing of the population we serve. Our Operational Plan is being developed in line with NHS England’s (NHSE) Five Year Forward View that outlines clearly the direction for the NHS and why we need to transform services in order to meet the challenges of the future.

We know that to sustain NHS services we need to get better at preventing disease, not just treating it and encourage everyone to take on responsibility to manage their own care.  We also need to focus on inequalities within our local community and reduce variation in health outcomes. 

As part of this and in line with NHSE planning guidance, we are working in partnership to develop our five year Sustainability and Transformation Plan (STP) across the wider health and care system that includes Wiltshire and Swindon.  Our Operational Plan represents year one of the longer term plan to improve health outcomes for the people of B&NES.  The priorities and goals in our STP will be developed by the CCGs, councils (including Health & Wellbeing Boards) and providers across the three local authority areas.

CQC Inspections

The Care Quality Commission (CQC) is the independent regulator of all health and social care in England.  The CQC has very recently carried out an inspection of the RUH.  As part of the inspection, the CQC proactively sought feedback from patients, their families and the wider public.  This included holding two engagement events in central Bath and Trowbridge. An inspection of South Western Ambulance Service NHS Foundation Trust takes place in early June.

The CQC is carrying out a programme of checks at GP practices in B&NES.  Inspections at Catherine Cottage and Rush Hill Surgery have been completed and both were rated as ‘good’.

Councillor Paul May commented regarding the STP that he found it strange that as a Council we were being pushed towards using services within Wiltshire more so than Bristol and that he wished to register his concern.

Councillor Geoff Ward asked if the figures relating to A&E performance were a seasonal issue and what was being done to achieve the target of 95%.

Corinne Edwards replied that there was usually a dip in the performance at the end of quarter 3 and throughout quarter 4. She added that following the ‘Home for Christmas’ campaign which took place towards the end of 2015, a review of the lessons learnt had taken place which would be taken into account for the 2016/17 winter. She said that work was ongoing regarding patient flow, discharges and home care provision and that they were providing monthly updates to NHS England on their plans. She said that the SRG continues to oversee the system actions that should see improvement in performance with the trajectory aiming to achieve the national target by June 2017, but dipping again at the end of quarter 3 throughout quarter 4.

Councillor Tim Ball said that elderly residents in his ward were worried about the prospect of travelling to Bristol for hospital appointments and felt that the Council should hold its ground for the moment.

The Chair commented that a number of services are not available at the RUH and that Bristol must be considered alongside Wiltshire as one of our options for residents.

Councillor Paul May said that he felt sure that patients in Whitchurch would not want to travel to Swindon as it was too far away.

Corinne Edwards said that she was mindful that discussions of a similar nature about the STP footprint were taking place across the other Local Authorities in the area.

The Director of Adult Care and Health Commissioning said that the matter of the STP footprint had also been debated by the Health & Wellbeing Board and that it was acknowledged that the boundaries between STPs could accommodate different footprints for other plans and/or partnership arrangements with a particular emphasis on what is right for the B&NES population. She added that there were positives to be gained through these proposed changes because B&NES does share some common issues with Wiltshire, including utilization of the RUH and need to ensure a sustainable urgent care system.

The Cabinet Member for Adult Social Care & Health, Councillor Vic Pritchard stated that the STP was an NHS England directive that had degrees of financial reward attached to it. He added that he was assured following a discussion at a West of England Leaders meeting that borders on this matter would be porous.

Councillor Eleanor Jackson commented that patients from Radstock find it difficult to travel to Bristol for appointments and said that they should be given the choice of where they would like to go. She asked if there had been a high uptake of the flu vaccination in the last year and what could be done to increase it.

Bruce Laurence replied that the figures relating to the flu vaccination were not high and that it was particularly difficult to persuade young people that it is something they should have.

Councillor Eleanor Jackson asked if cases of H1N1 had been found at St. Nicholas School.

Bruce Laurence replied that H1N1 had been diagnosed in some schools in the local area and that he would send further information to the Select Committee after the meeting.

The Chair thanked Corinne Edwards for her update on behalf of the Select Committee.