Agenda item

The Panel will receive an update from the B&NES, Swindon & Wiltshire Integrated Care Board (BSW ICB) on current issues.

Laura Ambler, Place Director for Bath and North East Somerset, BSW ICB addressed the Panel, a copy of the update will be available as an online appendix to these minutes, a summary is set out below.

Expansion of elective care at Sulis Hospital Bath

Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board (BSW ICB) and the Royal United Hospital Bath (RUH) are jointly developing a plan to provide additional capacity for elective surgery to reduce waiting times across Bath and North East Somerset Swindon and Wiltshire.

The expansion of elective surgery will be provided through the addition of three new operating theatres at the Sulis Hospital Bath in Peasedown St John. The new Sulis Elective Orthopaedic Centre (SEOC) could offer treatment for 4,000 NHS orthopaedic patients a year and address the high number of patients currently waiting for elective orthopaedic procedures.

£30m of national capital is available to help create this facility by 2025; the RUH and system colleagues are currently working up the business case to enable access to this funding.

The new facility would also help to free up capacity at the RUH’s main site at Combe Park and help patients awaiting treatment from other surgical specialties, complex cancer cases and managing non-elective care. The SEOC would support around 2,000 patients within the local catchment, with the remaining capacity available to orthopaedic patients across the wider BSW patch and beyond.

Care coordination project

Over the last few weeks, health and care partners across BSW ICB have been

working together as part of an ambitious programme to coordinate elements of care across the entire system, from pre-hospital and acute admission through to discharge and community response.

The Care Coordination project brings together BSW ICB, South Western Ambulance Service NHS Foundation Trust, local acute hospitals, providers, Medvivo, Avon and Wiltshire Mental Health Partnership, local authorities, primary care services and hospices.

Partners have been working together at a central location in Chippenham to provide patients with the right level of response. Often patients access emergency care via the ambulance service. The care coordination centre is looking to get patients to the right service for their needs.

The project is helping to ease pressures on the ambulance service as well as the wider health and care system.

Paediatric Urgent Service Hub

From 16th January, BaNES-based GP Federation BEMS will be mobilising the rollout of a Paediatric Urgent Service Hub for children aged five and under who are presenting with symptoms of fever, with the aim to reduce pressures on both primary and secondary care.

GPs are currently being recruited to work in this service. Clinics will run between 1pm and 5.30pm on weekdays from one location per day at a GP Surgery in Bath and North East Somerset.

Appointments will be same-day bookable, 15-minute slots, with full access to the patient record and direct access to support from the RUH Paediatric team.

Community Services Transformation

Laura informed the Panel that they are currently assessing different organisational options in terms of our future strategic requirements for Community Services. Richard Smale and I would be available to discuss the matter further if required.

Councillor Liz Hardman commented that the expansion of elective care at Sulis Hospital is particularly welcoming. She suggested that to engage with the wider stakeholder population, why not use the forums developed across BANES such as those in Keynsham, Bath and Midsomer Norton to find out residents’ views.

Laura Ambler thanked Councillor Hardman for that suggestion and said that the Forums could be addressed in future discussions.

The Chair added that a forum was also present in the Chew Valley.

Councillor Paul May asked if the Sulis Hospital would still be providing treatment to private patients.

Laura Ambler replied that as far as she was aware it would continue to provide these services during and following the expansion. She added that a business case was being developed and would be ready by April 2023.

Councillor May asked if the ICB Strategy document that has to be submitted to the Government can be shared with the Panel.

Laura Ambler replied that it is the Integrated Care Partnership that has to prepare the Strategy and that information relating to it is in the process of being gathered.

Councillor May asked what the timeline for submission was.

Laura Ambler replied that a draft was scheduled to be ready in March with a final document to be submitted in June.

Councillor Michelle O’Doherty asked if the new processes / strategies in place at the RUH were helping with the discharge of patients and ambulance waiting times.

Laura Ambler replied that it remains a complex picture and that ambulance flow remains difficult. She added that they were working across all parts of the system to ease pressure where possible. She said that the current strategy was preventing things from getting worse and they were aware that there was more to do.

The Director of Adult Social Care added that there has been a noticeable improvement over the last three weeks with the Care Coordination Centre working with people to ease hospital admittance.

Kevin Burnett asked if the funding mentioned for initiatives in the update was new from the Government and was it intended to compliment the HIP (Health infrastructure Plan) programme.

Laura Ambler replied that some of the funding was new, for example, the Adult Social Care Discharge Fund has a national figure of £500m. She added that recently there had also been an additional Hospital Discharge Fund and that guidance on that was still being received. She said that an allocation for the BSW region was not yet known, but an overall figure of £200m was available in total. She felt that a figure of around £3m - £4m could hopefully be received locally.

She said that this was very welcome and was helping with some of the elements of winter pressures. She added though that there was still further work to do on preventative measures and highlighted the good work of such initiatives as Virtual Wards and Hospital at Home as well as the intention to advance provision within the community as part of the transformation process.

Councillor Ruth Malloy asked if some further information could be given regarding the Virtual Wards.

Laura Ambler replied that the RUH already has a scheme known as Hospital at Home as this is used for patients that are within an acute setting, in hospital, and through their agreement and that of their clinician they can return home and be monitored and receive care provision at home. She added that this is typically a scheme for older people currently.

She said that there was also potential to advance the scheme so that in some cases hospital admittance can be prevented by referrals to the scheme from GPs or via the Care Coordination Centre.

Councillor Ruth Malloy asked if a person living alone would be eligible for the scheme.

Laura Ambler replied that it was possible for someone living alone to be part of the scheme, but it would need to be suitable for them and agreed by their Clinical Lead.

The Chair asked if the use of email could be encouraged to notify people of their hospital appointments, as opposed to post, following an initial consultation with their GP. He said he thought this would help a number of people, especially in rural areas such as the ward he represents. He explained that due to the recent postal strike some letters had been arriving after the appointment had been due to take place.

Laura Ambler replied she would relay that message to colleagues.

The Chair thanked her for her attendance on behalf of the Panel.