Agenda item

Councillor Marcus Franks introduced the item to Members of the Board and invited Tandra Forster to speak to the Adult Social Care section.

Tandra Forster reported that ASC1; Proportion of older people (65+) who were still at home 91 days after discharge from hospital to reablement/rehabilitation service was currently on target. The data for the target represented a small cohort and therefore percentages fluctuated very easily.

Regarding AS3 under the acute section of the Dashboard; Average number of delayed transfers of care which were attributable to social care per 100,000 population (18+), Tandra Forster reported that the target was amber and that work was underway to increase social worker presence in hospitals and commissioning in rural areas.

Shairoz Claridge introduced the acute section of the Dashboard. The Royal Berkshire Hospital (RBH) was currently amber on the four hour Accident and Emergency Target (AS1). This was still a reflection of the increase in demand throughout December, however, the RBH was one of the first hospital trusts in the area to show recovery. Shairoz Claridge reported that Newbury and District Clinical Commissioning Group (CCG) was not the lead commissioner for the Great Western Hospital or Hampshire Hospitals NHS Foundation Trusts, both of which were performing below target for the four hour Accident and Emergency indicator however, work would be ongoing to improve this. As of February Shairoz Claridge reported that RBH had achieved 94.7% and therefore was closer to reaching the 95% target.

Shairoz Claridge drew attention to AS5; Ambulance Clinical Quality – eight minute response time, which was currently red. She reported that due to the Christmas period, there had been pressures experienced across the country. This pressure was now beginning to reduce and a period of recovery had begun. Councillor Marcus Franks queried whether the main pressure was the failure of the Accident and Emergency service or demand. Shairoz Claridge reported that it was a combination of both demand and excessive pressure of Accident and Emergency services. Tandra Forster added that increased pressure was a nation wide issue. Carolyn Lawson stated that the South Central Ambulance Service (SCAS) had reported that calls had  increased by a third from the same period last year, so although it was a combination of factors that increased pressure on the system, there was also a underlying increase in numbers.

Shairoz Claridge moved onto the primary care section of the dashboard and reported that once co-commissioning started between the CCG and NHS England, reporting would become more robust. Currently only soft intelligence was being collected and a discussion needed to take place at the Management Group as to whether this information should be reported to the Board, even though it was not suitable for the dashboard.

RESOLVED that Shairoz Claridge would confirm whether soft intelligence gathered from Primary Care was suitable for the Health and Wellbeing Board.

Councillor Franks had noted at a Call to Action event, that appointment information had been available. Dr Bal Bahia was not sure that this information could be used to indicate resilience. Dr Barbara Barrie reported that Call to Action was about access to service, whereas resilience was about what additional resources were required when services were under pressure.

Carolyn Lawson reported that there had been an 8% decrease in minor injuries across the West Berkshire population.

Rachael Wardell introduced the Children’s Social Care section of the dashboard. She reported that when the dashboard had come to the Board in January the Children’s section had been predominantly green however, she had warned that an increase in pressure would cause targets to be pushed into the red and this was what had happened. Remedial action was detailed on the dashboard regarding red indicators. Looked After Children and child protection plans were only applied when necessary and work was taking place to manage the numbers down through early intervention. Permanent family solutions were being sought for Looked After Children.

Regarding CSC6; Child protection cases, which were reviewed within require timescales, it was a recognised issue that social workers made recommendations for one sibling rather than all and this was being reviewed and training was taking place.

Adrian Barker asked if there was a clear reason why the number of child protection cases had increased. Rachael Wardell reported that it was difficult to pin point however, there were increasing pressures on families including insecurities around work and homes. Despite increased effort around early intervention, it was possible that these was still not enough being done at this important stage and there was little capacity to expand.