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.

Launch of the Long Term Plan for the NHS

The launch of the Long Term plan for the NHS, which sets out how the additional £20.5 billion a year in real terms by 2023/24 will be spent, took place earlier this month. The LTP highlights improved neonatal care, that England is to be covered by integrated care systems in just over two years, and a greater investment in primary, community and mental health care. You can view the Long Term Plan at www.longtermplan.nhs.uk

Operational Readiness for EU Exit

NHS England has issued guidance to CCGs and providers on actions that we should take to prepare in case the UK leaves the EU without a ratified deal – a “no-deal” exit. The guidance has been sent to all health and care providers, including adult social care providers to ensure that the health and care system as a whole is prepared.

Greater collaboration between three CCGs

Work is continuing with our two neighbouring CCGs in the Sustainability and Transformation Partnership to develop a joint Executive Team and shared working arrangements. To support a single management team, the three Governing Bodies agreed that the three organisations would streamline governance arrangements to facilitate joint and/or aligned decision-making.

All CCGs have been asked to deliver a targeted 20% reduction of running costs by start of 2020/21 in order to redirect £320m nationally to improving patient care and transformation as part of the NHS Long Term Plan.

The impact of this reduction for BaNES is circa £500k. We will develop plans across the STP over the coming months to show how we can deliver this reduction.

BSW STP has also made some key appointments. Councillor Jerry Wickham has been appointed as Chair of the STP Sponsorship Board. The position of Vice Chair has been taken by Dr Richard Sandford-Hill.

Smoke Free NHS 2019

The Royal United, St Martin's and Paulton Hospitals all went completely smoke free on 1 January. This means patients, staff and visitors can no longer smoke anywhere on site, including the grounds and gardens or in vehicles and car parks. There are no longer dedicated smoking areas on sites, however use of e-cigarettes will be allowed in outside areas.

New non-emergency patient transport service across BaNES, Swindon & Wiltshire

From 1 June 2019, the non-emergency patient transport service in B&NES, Swindon, Wiltshire and Gloucestershire will be provided by E-zec Medical Transport Services, replacing the service currently provided by Arriva Transport Solutions. E-zec are a family run company focused on delivering high quality, safe, effective transportation for patients to and from a healthcare setting. E-Zec will be working closely with the CCGs over the coming months to prepare for a seamless handover of service arrangements.

A&E performance

Local system performance against the A&E waiting time target (95 per cent of attendees to be seen within four hours) during November was 76.9%; data for December was not available at the time of writing. The A&E Delivery Board has developed a strong winter resilience plan which includes the recruitment of additional community staff to support more patients leaving the hospital on a Home First pathway which enables them to be re-assessed for their on-going health and care needs in their own homes.

Consultation on proposals to reduce prescriptions for low priority items

NHS England and NHS Commissioners have launched a national consultation on proposals to curb the prescription of low priority items such as silk garments and bath oils.

The consultation is asking members of the public and healthcare professionals for their views on a range of products that are deemed to be:

• items of relatively low clinical effectiveness
• items which are clinically effective but where more cost effective items are available or
• items which are clinically effective but, due to their nature, are deemed a low priority for NHS funding.

The eight products being consulted on cost the NHS more than £68m.

Launch of NHS App

A new NHS App is now available on Google Play and Apple and is gradually being rolled out across England following a successful pilot. The NHS App provides a simple and secure way to access a range of NHS services on a smartphone or tablet.

Developed and run by the NHS to improve access to digital healthcare services, the NHS App enables people to check their symptoms, use NHS 111 online, book and manage appointments at their GP surgery, order repeat prescriptions, securely view their GP medical record and more. The App is also the first major platform to use the new NHS login, a single, easy to use system for verifying the identity of those requesting access to digital health records and services.

Patients will be able to access lots of key features of the NHS App. However, the functionality for patients to book and manage appointments at their GP surgery, order repeat prescriptions, securely view their GP medical record will only be available when their GP surgery is connected during the rollout. Patients can check if their GP surgery is connected when they open the app for the first time. If the surgery isn’t connected, patients can leave an email address and will be notified when it is.

Councillor Tim Ball commented that he had tried using the app and found it to be virtually useless. He said that he felt it could in some cases cause more problems than solutions as many members of the public are not of a digital age.

Dr Orpen replied that the app should be seen as another way into the system and a way for patients to look at their records or check for information such as a blood test result. He added that regular options for contacting surgeries would not be shutting down.

Councillor Eleanor Jackson asked for further information regarding the Brexit contingency plans.

Dr Orpen replied that he would ask that members of the public do not attempt to stockpile their medicines / pills as this could cause problems. He added that NHS England has been assessing this matter for some time and it is a high priority for them.

Councillor Jackson asked why it can still take a month to get an appointment to see a GP, even for a consultation to change medication.

Dr Orpen replied that quite simply demand has risen and there are not enough GPs to meet the demand. He said for example through a combination of seeing patients first thing in the morning, attending meetings, holding an afternoon surgery and then writing letters he will quite often work a 13 hour day. He added that the services available in the local area are as good as many areas of the country.

Councillor Lin Patterson asked if he could inform the Select Committee of any specific measures to be taken relating to Brexit.

Dr Orpen replied that he did not have any details to hand, but wished to assure them that extensive planning has been undertaken and that contact on a weekly basis has been maintained with NHS England.

The Acting Director for Integrated Health and Care Commissioning added that local providers have been contacted on the possibility of ‘no deal’ with respect to medicines and staff. She added that some responses were outstanding, but were due in by then end of the month.

Councillor Bryan Organ thanked Corinne Edwards, B&NES CCG and Councillor Pritchard for arranging a recent meeting regarding non-emergency patient transport. He said that the general impression was that there are a lot of services available to the public.

Councillor Pritchard added that it is planned for an inventory of services to be made and then consideration will be given as to how best to disseminate the information to the public.

The Chair stated that she wished to personally congratulate the RUH on its A&E performance as she had to attend recently and was in and out within 30 minutes.