Meeting: Urgent and Emergency Care System Delivery Board
Meeting Date: 2 March, 16 March and 30 March 2021
Key Decisions and Actions:
The Board discussed the ICP Priority Setting Process for 2021/2022 and agreed the three proposed priorities with the need to refine and streamline the scope and objectives.
The Board heard updates around digital health, NHS 111 First, the Oximetry at Home Service and the implementation of the SHREWD application at LTHTR, the following was noted:
• The positive impact of the digital health service, proposals to extend the service was supported.
• The increased deflections from ED through NHS 111 First, positive progress against targets and the good position of central Lancashire in the region.
• The positive impact of the Oximetry at Home Service for patients, the excellent work of the team, and the learning and opportunities for the future.
• The benefits of the SHREWD system, is it provided real time information regarding patient wait times, beds and diagnostics via an app which sends alerts to mobile phones to support effective decision making and improvement in flow.
The Board welcomed the reduction in the number of inpatients at LTHTR, and noted the significant pressures in primary, community and social care, in particular mental health care, the increase in complexity of presentations, and increased complexity of category 1 patients. An increase was noted in section 136’s and referrals to all mental health teams. There was concern regarding the number of unallocated cases to community mental health teams. This was acknowledged and the Board was informed that a process was in place to mitigate risks. Discussions at the ICP Covid Command and Control meeting had focussed on how to address this and work had commenced to produce a dashboard and metrics to monitor these pressures. Discussions would be held at the meeting this week to ensure provision was in place to manage pressures over the Easter weekend. It was noted that LTHTR had implemented a “home for Easter” campaign and actions were being taken to focus on discharges, additional capacity had been provided for home first and LCC social care teams. The Board was advised that standard daily reporting was expected to continue over Easter and there would be national calls on Sunday and Monday in terms of plans for discharges.
Opening hours at Chorley ED had increased to 12 hours from 15 March, attendances continued to be monitored daily as part of internal measures. Quality impact assessments had been discussed to give assurance in terms of safety and mitigation of risks. The Performance Dashboard showed an increase in activity in A&E and DTOC, and as opening hours had increased attendances at CDH would be monitored.
The Board was pleased to note the positive situation in community teams and that funding had been secured for the next quarter continue to Home First at the increased capacity. The Board fully endorsed the proposals in the commissioning paper and awaited the outcome of discussions at SLT.
The new operational planning guidance and the requirements for transforming Community and Urgent and Emergency Care, and expanding Primary Care was discussed. It was agreed that this document should be considered by all the System Delivery Boards as part of the ICP Priority Setting Process and the requirements reflected in the agreed priorities.
There was recognition of the impacts of the last year on the workforce and that staff in all services were fatigued. The importance of staff health and wellbeing was acknowledged along with the need to balance this with the requirements of the new operational planning guidance. Staff health and wellbeing would form part of the standing agenda moving forward.
Matters for Escalation (and where to)
Completed and Signed off by Lindsey Dickinson, Clinical Lead (11 and 16 March) Faith Button, Senior Lead (30 March