Agenda item

Ivor Duffy (Director of Assurance and Delivery, NHS England South (South East)); Rachel Jones (Director of Commissioning and Performance, NHS Dartford, Gravesham & Swanley CCG & NHS Swale CCG); Simon Perks ( Accountable Officer, NHS Ashford & NHS Canterbury and Coastal CCGs) and Adam Wickings (Joint Chief Operating Officer, NHS West Kent CCG) were in attendance for this item.

(1)       The Chair welcomed guests to the Committee. Mr Duffy introduced the Winter Preparedness report, highlighting the fact that planning for winter had begun during the previous year and that two ‘wash up’ exercises were undertaken.  He noted that the 2017 assurance processes had been much more robust, with considerable joint working and information sharing with NHS England and other relevant partners, supported by significant testing of the plans to confirm that they were practical and effective.

(2)       Responding to Member questions regarding the seasonal flu vaccination uptake, Mr Duffy advised the Committee there was no authority to require anyone to receive the flu vaccine, NHS England had contributed significant resources to provide for social care staff and partners who wished to receive the vaccination.

(3)       Mr Wickings advised the Committee that the previous winter had posed challenges for the West Kent health economy, particularly in relation to patient discharge management involving care home provision and other factors.  He advised that work had been undertaken, supported by some additional BCF funding, which had addressed these issues to some extent, reducing the discharge delays.  Mr Wickings explained that work was ongoing around the Home First approach, which sought to ensure that those with the most significant frailty could have needs addressed appropriately in a way that minimised any delays to discharge; this involved ensuring processes were in place to manage ongoing care assessments and support plans outside of the hospital setting.  Mr Wickings commented that while the planning work had been positive and that progress had been made, winter always presented significant challenges to the NHS and he assured the Committee that these challenges were taken very seriously.

(4)       Ms Jones highlighted the challenges in the North Kent health economy related to domiciliary care.  She advised that work was ongoing to engage with relevant providers to identify solutions.  While this had not yet addressed all issues, Ms Jones advised the Committee that preparations were better in 2017 than they had been in the previous year.  Ms Jones also commented on the specific issues relating to Darent Valley Hospital as a key link with London whereby its demand level for care and support resources included patients from outside the CCG area.

(5)       Mr Perks highlighted the specific issues affecting the East Kent health economy, including having one of the worst performing A&Es in the country.  This meant that there was a risk around capacity to handle surges in demand over the winter period.  He noted that in previous winters, East Kent had managed most issues fairly well, with a surplus beds being available.  However, the changes to acute care meant that this would not necessarily continue.  Mr Perks commented that joint working with key partners was ongoing, which was expected to allow some other parts of the health care sector to take some of the pressure when demand surges occurred.  He highlighted the positive impact of the joint working, advising the Committee that the silo working which had been criticised previously had been replaced by a much more co-operative partnership approach to managing key issues around health and social care.

(6)       Mr Duffy commented work was being undertaken by NHS England to ensure best use of the BCF funding to support effective hospital flow, whereby patients could be moved and managed where it was most appropriate, taking into account both the patient’s needs and service capacity.  This had been presented to the Kent Health and Wellbeing Board.  He also explained that work was being done around the mutual aid programme to help support effective sharing of resources around the county to deal with pockets of demand surge.

(7)       Responding to Member questions, Mr Duffy explained that NHS England had been supporting effective communication about the availability of primary care services over the Christmas period.  This involved ensuring appropriate advertising and information sharing was put in place.  Mr Perks commented that the East Kent Hospitals communications team, now under a single director, had developed a more cohesive message around accessing services appropriately.  This included making people more aware about the services available from the minor injury units, pharmacists and self-care advice.  He advised that it was hoped that this approach would reduce unnecessary demand at A&E.  Mr Perks and Mr Duffy confirmed that these communication programmes would include appropriate methods to reach different parts of the community, such as social media, apps, online information and leaflets.  Mr Perks highlighted the benefits of the Waitless App, which directed people to the most appropriate service, taking into account waiting times.  He noted that the usefulness did depended on patients being able to access transport to get to alternative care sites.  Members agreed with the positive use of the Waitless App.

(8)       RESOLVED that the report be noted and NHS England be requested to provide an update about the performance of the winter plans to the Committee at its June meeting.

The meeting was adjourned at 12:45 and reconvened at 13:30.