Agenda item

 (Councillor Gordon Lundie declared a personal interest in Agenda item 8 by virtue of the fact that he sat on the Council of Governors for the Royal Berkshire Hospital . As his interest was personal and not prejudicial he was permitted to take part in the debate and vote on the matter).

Tandra Forster introduced the item to Members of the Health and Wellbeing Board and briefed them on the Adult Social Care section of the dashboard. She highlighted that performance had dropped slightly for ASC1. The data for this measure however, referred to a very small cohort of people and therefore it only took one person to change the percentage significantly.

Councillor Gordon Lundie reported that he was aware of new funding that was attached to Delayed Transfers of Care (DTOC) and asked for an update. Rachael Wardell explained that money had been made available by the Department of Health (DH) specifically for hospital discharges. However there were a number of obstacles in the way of improving performance in this area and adding money was not necessarily the answer. More of what was already working well needed to take place and people who might be at risk of having a delayed discharge needed to be identified on admission. Effort needed to focus on identifying blockages in the system and targeting these areas. It was for health partners to decide the best way in which the money should be used.

Councillor Lundie further questioned how well plans were aligned with the Royal Berkshire Hospital (RBH). Tandra Forster reported that they had moved towards a trust performance system. The RBH had issues regarding a number of Care Homes.

Tandra Forster further added that the performance team were working hard to get people out of hospital efficiently. Funding had to be used by the end of the year, which was going to be challenging.

Councillor Lundie queried what the DTOC data actually represented. Tandra Forster confirmed that one of the DTOC figures was a snapshot taken on the third Thursday each month. Once a person was assessed as being well enough they were released from hospital as soon as possible, however there were a number of factors that could hold this process up such as medication, or issues at home. Those in the system had to work together to support someone leaving hospital. It was acknowledged that the longer someone stayed in hospital the higher the risk that they would become dependant on services.

Rachael Wardell added that there were often a number of people on the Fit to Go list (Fit List) however, had not yet been discharged.

Shairoz Claridge added that focus was required on those medically fit to be discharged. Tandra Forster confirmed that she had the current Fit List for the RBH and positively it was at zero.

Rachael Wardell explained that one of the DTOC measures (AS2) showed all delays and the other (AS3) showed only those attributable to Social Care. These measures were helpfully broken down by individual hospital trusts.

Adrian Barker referred to the two DTOC indicators AS2 (all delays) and AS3 (delays attributable to Social Care) and queried why the figures attributable to Social Care were higher than those for all delays regarding both Berkshire Healthcare Foundation Trust and Hampshire Hospitals Foundation Trust.

RESOLVED that Tandra Forster confirmed that she would check DTOC figures with the relevant colleagues and feedback the answer to Adrian Barker’s question to the Board.

Councillor Lundie queried if the issues discussed on the dashboard were also on the relevant forward work plans. Shairoz Claridge confirmed that the acute section was discussed at the Urgent Care Board. She added that a report on winter resilience was currently under construction and a report would be brought back to the Board meeting in March.

Councillor Lundie queried how pressures faced by the RBH were being taken into account. Shairoz Claridge reported that the Urgent Care Board had actions in place to help address these pressures. Daily updates on figures were also provided and helped RBH deal with the pressures.

Shairoz Claridge referred to the pressures faced across the county by Accident and Emergency departments. She reported that anecdotal information she had received indicated that cases being presented at Accident and Emergency departments were appropriate.

Shairoz Claridge reported that Accident and Emergency figures had peaked over the Christmas period however, this had now levelled off and it was a national issue. Shairoz Claridge stated that she would ask the Urgent Care lead to present the winter resilience information to the next Board meeting in March.

Dr Barbara Barrie felt that Primary Care’s efforts to mitigate the winter pressures was often excluded, and therefore many surgeries had carried out an audit of appointments dealt with over the Christmas period. This gave a snapshot of each practice. Dr Bal Bahia reported that results for his surgery showed that there had been a 14% increase in consultations and 18% increase in phone calls over the Christmas period.

Nikki Luffington felt that the data contained on the dashboard was out of date as quarter three information was available. She reported that DTOC was on the national agenda and quarter three data for West Berkshire showed that it was underperforming.

Councillor Marcus Franks responded to Nikki Luffington’s point about the data being out date. In this instance this was largely due to different reporting timescales because of the Christmas period. However, this would be raised at the Management Group.

RESOLVED that the reporting timescales for the dashboard to be discussed at the next meeting of the Health and Wellbeing Management Group.

Shairoz Claridge reported that they were working with NHS England to make the Dashboard as live as possible.

Adrian Barker suggested that an indicator be included on the Dashboard, which showed the number of people seeing General Practitioners.

RESOLVED that Nikki Luffington would look into this.

(Councillor Gordon Lundie left the meeting at 9.30am)