Agenda item

(To receive a report from Ruth Cumbers, Urgent Care Programme Director, which updates the Committee on planning for Winter Pressures across the Health and Care Economy in Lincolnshire)

Consideration was given to a report from the Lincolnshire East Clinical Commissioning Group (LECCG), which provided an update on planning for winter pressures across the health and care economy in Lincolnshire.  The Committee was also asked to give consideration to a report from the Council's Executive Director of Adult Care and Community Wellbeing, which provided the Committee with details relating to the performance on Delayed Transfers of Care.

The Chairman welcomed to the meeting Samantha Milbank, Accountable Officer, Lincolnshire East Clinical Commissioning Group and Lynne Bucknell, County Manager, Special Projects and Hospital Services.

In guiding the Committee through the report, the Accountable Officer, LECCG advised that it was essential that a 'whole system' approach was taken to anticipating how and where in the system increased demand was likely to present, and to the planning of appropriate inter-agency responses to ensure that no part of the system was overwhelmed or unable to function.

The Committee noted that the A & E Delivery Board had effective leadership and that the draft winter plan had been submitted to regulators for review and assurance prior to 7 August 2017.  The Plan had been assured by the Regulators, NHS England and NHS Improvement, and had been signed off by the Lincolnshire A & E Delivery Board on 14 November 2017.  A summary of the various areas involved in the plan was detailed within the report presented.

The County Manager, Special Projects and Hospitals Services provided on page six of the supplementary report, details relating to Delayed Transfer of Care (DTOC) Targets.

A table on page seven provided data relating to all hospitals adult care delayed days over a six month rolling period.  The graph demonstrated that there had been very low Adult Care delays over the last six months across the acute hospitals.  It was reported that Adult Care had continued to meet local Better Care Fund Delayed Transfer of Care Targets.

During discussion, the Committee raised the following points:-

·         Some of the members felt that the report should have been presented to the Committee earlier in the year.  Officers noted the request and agreed to ensure that the Committee had sight of the report at an earlier stage of the process;

·         Lack of beds – The Committee was advised that the flexible system approach was to avoid admission where possible by moving the patient to primary care;

·         The need to include the provision of transport in future years plans;

·         The reduction in elective work during the winter period, to give better capacity to the system as a whole;

·         Promotional Campaigns – Encouraging people to 'Stay Well this Winter';

·         That the majority of DTOC's were as a result of NHS issues.  It was highlighted that 79.35% of DTOC's were achieved at Lincoln County Hospital, where as Grantham Hospital was achieving 96.13% of the four hourly wait figure.  Officers advised that the A & E waiting at Boston and Lincoln Hospitals was different.  There was streaming at Boston and Lincoln as there was a higher volume of patients.  The Committee was advised further that Grantham A & E had a GP model and streaming was therefore embedded;

·         Vulnerability of Patients – There were concerns raised that if there was a blockage in one area,  it then had an effect elsewhere in the system; and

·         Ward Closures – The Committee noted that wards were occasionally closed as a result of viruses.  It was also highlighted that wards might be closed if there was insufficient staff to safely opperate them.

RESOLVED

1.    That the report on winter pressures be noted.

2.    That the supplementary report concerning Delayed Transfers of Care be noted.