Agenda item

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

Dr Ruth Grabham 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 against the A&E waiting time target (95 per cent of attendees to be seen within four hours) was 81.3 per cent in November against a trajectory of 90.5 per cent and 86 per cent for December against a target trajectory of 91 per cent.

The local health and care system maintained relatively good performance between the Christmas and New Year period delivering 86.3 per cent for week ending 1January 2017.  However since then there has been extremely high demand and this is putting local health and care services across the area under significant pressure.

Some non-urgent hospital appointments and operations have been rescheduled and extra staff have been deployed to the emergency department and hospital wards. Extra beds have also been made available in care homes so frail elderly patients can be discharged from hospital more quickly.  The maternity beds at Paulton Birthing Centre have also been temporarily closed to accommodate patients who have been discharged from the RUH but are not yet well enough to return home or to another care setting.

Sustainability and Transformation Plan update

The Bath and North East Somerset, Swindon and Wiltshire (BSW) ‘Emergent  Sustainability and Transformation Plan’ was published on 14 December 2016 setting out how health and care organisations across the ‘footprint’ plan to work together in new ways to improve our local population’s health and wellbeing, improve the quality of services and ensure financial sustainability.

There are plans for launching a period of engagement with patients, carers and other stakeholders to support the further development of STP proposals - this is due to begin in February.

2017/18 Operational Plan

The CCG submitted its two year operational plan for the period 2017/18- 2018-19 to NHS England on the 23December in line with the nationally set deadline. The CCG’s Operational Plan is a detailed document that assures NHS England of our delivery plans against the nationally mandated “nine must dos”.

Delegated Commissioning

The CCG submitted its application to take over responsibility for commissioning of primary care services from NHS England on 5 December 2016.  The decision was supported by our member practices with a 96 per cent turn out and 83 per cent of practices voting ‘yes’.  We will announce the outcome of our application very shortly.

Engagement on stopping two groups of over-the-counter medicines (OTC) and gluten-free prescribing

We undertook a period of engagement between 26 November – 21 December on our proposals to stop prescribing of gluten-free products and two groups of over-the-counter medicines to treat minor ailments (pain killers and anti-histamines).  The outcome of the engagement process will be presented to the CCG’s Joint Clinical Commissioning Committee on the 26 January 2017 for review and to agree next steps.

Mental Health Pathway Review

The Council and the CCG have begun work with Virgin Care to scope out a full review of the mental health pathway in Bath and North East Somerset. The review will launch later this year and the results will be made available in September.

NHS111 and GP out-of-hours service

The procurement process is underway to deliver a more joined up NHS111 system across B&NES, Swindon and Wiltshire.  GP out-of-hours services are being re-procured across Wiltshire and B&NES.  A period of public engagement will launch in the next couple of weeks so patients’ experiences of our urgent and emergency care services can be used to shape the new services.

Councillor Geoff Ward asked what impact had the recent norovirus had on the RUH.

Dr Grabham replied that some wards had to be closed, relatives were urged not to visit where possible and that staff were not allowed back to work until completely well.

Councillor Geoff Ward asked if she could comment on any cases of bed blocking locally.

Dr Grabham replied that patients will be offered a choice of care and that they have the right to choose. She added that around 40 patients a day are flagged as ‘green to go’. She said that the availability of carers can also be a contributing factor.

Councillor Dine Romero asked Mental Health Pathway Review would include children and young people.

The Director for Integrated Health & Care Commissioning replied that the whole pathway was within her remit, but the focus of the review was on Adult Services. She added that the review would look at integrated community provision and try to ensure pathways are smooth, yet flexible. She said that integration was needed as recipients of the service move from child to adult services.

Councillor Paul May asked that the Select Committee be consulted as part of the public engagement regarding both the STP and the NHS111 and GP out-of-hours service.

Dr Grabham said that she had noted the request.

Councillor Eleanor Jackson asked if the issue relating to bed blocking was due to the time taken to get the correct care package in place and how it will be funded.

The Director for Integrated Health & Care Commissioning assured the Select Committee that she and Caroline Holmes were not in dispute regarding packages of care. She said that decisions are made within 24 hours of a care package being assigned.

Councillor Eleanor Jackson asked if any Paulton patients were affected by the decision to accommodate patients who had been discharged from the RUH, especially expectant mothers.

The Director for Integrated Health & Care Commissioning replied that the birthing suite was not affected and that births did not take place in other facilities as a result of this decision.

Councillor Eleanor Jackson asked if funding for the new Hope House Surgery in Radstock had been approved as part of the Transformation Fund.

Dr Grabham replied that it had.

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