Agenda item

(To receive a report from the Multi-Agency Lincolnshire Systems Resilience Group (SRG), which outlines the key drivers, requirements and highlights of the Lincolnshire SRG System Wide Winter Plan 2015/16)

Consideration was given to a report from the Chairman of the Lincolnshire System Resilience Group, which outlined to the Board the key drivers, requirements and highlights of the Lincolnshire System Resilience Group System Wide Winter Plan for 2015/16.  The plan outlined how collectively Lincolnshire Commissioners, providers and voluntary and community sectors would collectively prepare, respond and recover from Winter 2015/16.

It was reported that the winter plan was underpinned and organised according to the principles of integrated emergency management: Anticipate; Access, Prevent; Prepare; Respond and Recover.  The plan also identified the shared risks across the health and care system and the joint mitigations in place to reduce risk levels.  It was highlighted that the plan was a live working document, and as such would be updated up to the week before Christmas.  It was noted that the Plan was guided by national frameworks and expectations such as the Public Health England Cold Weather Plan.

The Board were asked to note the highlights of the Plan, which were detailed on page six of the report presented.

A copy of the Lincolnshire System Resilience Group System Wide Winter Plan 2015/16 was attached at Appendix A to the report.  In guiding the Board through the Plan, particular reference was made to:-

·         Page 27 – That for the first time, the youngest primary school children would be eligible to receive the free nasal spray vaccine;

·         Page 28 – That Lincolnshire County Council had funded flu vouchers for contracted domiciliary care workers in the County, and that any surplus from the flu vouchers procured would be offered to contracted residential care homes for their staff;

·         Page 29 – Paragraph 4.3 - Business Continuity Plans were seen locally as a key vehicle for ensuring quality and access to services was maintained through periods of system pressure;

·         Page 29 - Paragraph 4.4 – The role of Neighbourhood Teams with the voluntary and community sector.  It was highlighted that the TED initiative in East Lindsey to combat loneliness and isolation played a vital element in maintaining winter community resilience;

·         Page 31 – It was highlighted that the Clinical Assessment Service was to be phased in from November 2015.  The integrated services was provided by LCHS, Care UK, EMAS, LFPT and ULHT and provided enhanced clinical assessment with a view to decreasing the number of attendees at A & E departments;

·         Page 31 – Additional Primary Care Capacity.  It was noted that each practice was striving to improve access; that patients were educated about the importance of self – care, and were aware of the appropriate way for accessing care in different situations; extended hours of provision; assurance to NHS England on the quality of business continuity plans; reducing staff sickness through winter by maximising flu vaccinations;

·         Page 33 – Acute Care Plans – It was highlighted that plans were in place to minimise hospital admissions; improve the flow of patients out of A & E into hospital, and through the hospital; and reducing delayed transfers of care to release hospital beds;

·         Page 34 - Transitional Care (Intermediate Care), Reablement and Home Care Capacity/Facilitated Discharge Teams;

·         Page 35 – Local Authority Plans – It was noted that the Local Authority had a critical role in ensuring that the system was able to cope through the winter, details of which were shown on page 35;

·         Care UK – 111 – The Board noted that the Service Resilience Group Dashboard included performance data for 111; and through the contractual process commissioners would ensure that 111 escalation plans were clear in terms of their communication in to the system; 

·         Page 38 – Mental Health Support – Psychiatric Liaison Services for the County – The Board were advised that the new multi-disciplinary Mental Health Liaison Service would be based at Lincoln, Grantham, Boston and Peterborough acute hospitals and would take referrals from acute trust staff, and also case-finding to deliver rapid assessment of mental health needs;

·         Page 39 – Excess winter deaths and wellbeing – It was noted that Public Health with Partners and Providers aimed to reduce excess winter deaths and improve well-being.  Partner agencies would be working to support the implementation of the proposed NICE guidelines 'Excess winter deaths and morbidity and the health risks associated with a cold home', targeting vulnerable people; and

·         Page 40 – This page provided a list of interventions being undertaken to increase an individual's resilience against the cold.

In conclusion, the Board were advised that the plan demonstrated a detailed and connected approach across health and care organisations to prepare, respond and recover to the presenting risks and challenges of the winter.  The Board welcomed the report.

During discussion, the Board raised the following issues:-

·         The inclusion of District Councils on the distribution list.  It was also reported that Districts had a wealth of knowledge and data about their area and their vulnerable people;

·         That the plan seemed like an NHS Plan, and as such did not tackle the big issue of the availability of Pharmacists across the County.  The rurality of Lincolnshire and the reduced openings over the Christmas period made it difficult for people to access the service if required.  It was noted that there was a problem with Pharmacists; however, anyone requiring the service was able to ring 111 and obtain information as to the nearest available Pharmacists to their location;

·         The need to encourage staff to have a flu vaccines going forward.  It was noted that organisations funded their own vaccines.  Some discussion was had as to the effectiveness of a flu vaccine.  It was highlighted that no vaccine was 100% effective, as the flu virus continually mutated, and it also took six months to produce a flu vaccine.  On the whole, the flu vaccine was effective at preventing flu, but not a cold.  It was highlighted that there was a need for a combined effort by all involved organisations to encourage staff to have a flu vaccine;

·         The positive impact that Neighbourhood Teams would have in the winter planning process going forward;

·         The need to include more reference to children and young people, children's paediatrics and the need to look into increased use of Children's Centres by Health Visitors; and

·         To help alleviate discharge blockages, it was highlighted that there needed to be more work done on the flow process, as the biggest delays were caused by NHS delays, such as assessments, prescriptions.  Eighteen out of twenty cases were simple, it was the cases that were more complex that were taking the time.  The plan was to have the most acute patients in and out within seven days.  

RESOLVED

That the report on the joint health and care system approach to winter planning be noted.