Agenda item

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

As this item began the Chair took the opportunity to thank Laura Ambler for her work with the Panel as this was to be her last meeting in her role as the Executive Director of Place for Bath and North East Somerset, BSW ICB.

Laura thanked the Panel and said it had been a pleasure to work alongside them. She provided updates on vaccination uptake, pharmacy campaigns, and digital interoperability.

Flu vaccine among health and care workers

Statistics from NHS England show that vaccination rates for health and care workers in each of the region’s three localities of Bath and North East Somerset, Swindon and Wiltshire are above the national average, which currently stands at 39.9 per cent.

Staff at all three acute trusts are continually encouraged to come forward for their vaccine, with regular clinics being held both on-site and in locations across the community.

Patients and public reminded to only order what they need

In the run-up to Christmas, the ICB is raising awareness of medicine wastage and encouraging people to only order what they need.

The NHS spends an estimated £300 million on unused medicines each year, with wastage happening when too much medication is order that isn’t needed, items are stockpiled at home or prescriptions aren’t checked before leaving the pharmacy.

People are now being reminded of how important it is to check what medicines they have at home before placing their repeat prescription order.

Councillor Paul Crossley stated that he remained staggered at the numbers of health and care workers that have not had a flu vaccination and said that there was a need to understand the reluctance.

Laura Ambler replied that they are trying to understand any concerns, including cultural and accessibility, and have asked staff to complete a survey relating to the matter. She added that targeted clinics have been put in place and staff reminded that the vaccinations are free for them.

Councillor Lesley Mansell said she would be interested to hear about any follow up information relating to the medicine wastage campaign.

Laura Ambler replied that she would relay this to colleagues.

Kevin Burnett asked if treatment provided through Pharmacy First would form part of a patient’s digital record.

Laura Ambler replied that SystmOne is the computer system used in the NHS that creates a single, shared Electronic Health Record (EHR) for patients, linking data across various care settings. She said she would ask colleagues within the digital team if this was yet linked to Pharmacy First.

Councillor Joanna Wright asked if an update on dental buses was available.

Laura Ambler replied that her colleague Victoria Stanley was aware of the need / ambition to have such a service and said that it was being looked into.

Councillor Wright raised the issue of personal data being held by HCRG and asked if there was confidence in their ability to protect this and not share it without permission.

Laura Ambler replied that HCRG have strict data processes in place and that they would need permission to share any personal data held by them.

John Palmer (Managing Director, RUH, Bath) joined the Panel meeting via Teams to discuss hospital performance, winter pressures, and improvement plans. He highlighted the following areas.

·  Due to combined operational and financial challenges, the RUH is in Segment 4 under the NHS Oversight Framework (NOF), quarter one of 2025/26. In the new acute trust league table published on 9 September 2025, the RUH was ranked 112th out of 134 acute providers.

·  The RUH is under significant financial and operational pressure and has seen a significant increase in terms of ambulance demand and emergency department attendances during the course of the year and exponentially since September, when wait-45 was introduced, whereby ambulance crews have a 45-minute time limit to hand over patients at an emergency department before leaving to respond to other calls.

·  These changes are significantly outside all planned assumptions and expectations in the order of 25 per cent for ambulance conveyances and 12 per cent for attendances.

·  The RUH has responded by strengthening its leadership team, implementing enhanced financial controls, launching an executive-led call-to-action, and appointing a turnaround team to focus specifically on financial recovery. Collaborative work with the Integrated Care Board to secure funding and accelerate improvements, principally for urgent and emergency care pathways and bed capacity is also happening.

·  Performance recovery plans have been implemented across all four performance areas, with positive trajectories in reducing long waits for elective care and diagnostics, and an extraordinary improvement in ambulance handover.

·  The next acute trust league table is due to be published shortly, and the RUH is expecting to see an improvement in its ranked position. Strong progress continues to be made against the RUH’s call-to-action recovery plan, and the trust expects to make ongoing improvements against its performance metrics and financial recovery for the remainder of the financial year.

Councillor Liz Hardman said that she welcomed the improvements that have been recently made by the RUH and asked if any direct intervention measures had occurred.

John Palmer replied that no direct interventions had taken place and described the current process in relation to tiered weekly meetings. He added that he was proud of all the staff at the hospital for showing that they want to respond to the position they found themselves in. He said that plans for both short and long-term improvements, including capital investment in emergency department facilities were ongoing.

Councillor David Harding requested detailed data on urgent care performance, including 4-hour and 12-hour waits.

John Palmer stated that further information was available via the hospital’s integrated performance reports. He added that they acknowledge that their 4-hour waits were not good enough and were committed to this improving.

Kevin Burnett asked if the proposed improvements would be sustainable.

John Palmer replied that there were here and now issues that need resolving alongside those which involve 3–5-years of planning. He added that the ICB were helping with some resourcing and stated that implementing a new Emergency Department within the hospital was important to the organisation.

Councillor Mansell asked if the results of the recent A&E patient survey were known.

John Palmer replied that information relating to the survey was not yet available.

Councillor Mansell asked if any further comment could be made about the impact of ambulance handover improvements and step-down facilities.

John Palmer replied that the ability to receive patients and to release ambulance crews in a timelier manner has enabled a better flow for the hospital. He added that they were committed to the step-down model, Ward 4 at St Martin’s Hospital, and ongoing work to manage demand and maintain performance.

The Chair thanked Laura Ambler and John Palmer for their update on behalf of the Panel.