Agenda item

Carolyn Lawson reported that on the 13^th June 2014, NHS England published a framework to support planning for operational resilience during 2014/15. Planning guidance encouraged systems to move beyond traditional winter planning for urgent care and consider a year round resilience across both urgent and planned care. It acknowledged that emergency services could not be looked at in isolation.

CCGs had been required to submit an Operational Resilience and Capacity Plan on behalf of their local health and social care economy, addressing the requirements outlined within the planning guidance. The aim was to meet the four hour Accident and Emergency target and the 18 week referral to treatment target.

The plan was approved in October 2014 and £2.6m of resilience money was allocated and divided up as detailed in Appendix A. £500k had been given to each provider. Organisations allocated money were asked to submit bids for schemes they wished to deliver. Carolyn Lawson highlighted that although the amount allocated to RBH (£500k) seemed low being the primary provider for the district, she stated that it had already been allocated a large sum of money from the local emergency tariff.

Looking historically at performance against the Accident and Emergency four hour target, there had been consistent failure to meet it throughout 2013/14. As a result a huge amount of diagnostic work had taken place. Table three under Appendix A linked the diagnostic work to each of the priorities.

The £2.6m was supplemented with other pots of funding dedicated to NHS 111 resilience schemes across the Thames Valley; South and Central Ambulance Service (SCAS) resilience across the Thames Valley and mental health resilience schemes. A further allocation of £1.09m was also received in November 2014. Receiving money so late in the year made it extremely difficult to spend it efficiently.

Carolyn Lawson referred to the description of the schemes detailed on page 36 of appendix A, including Urgent Hospital Assessment and Urgent Care Delivery, which considered issues around rurality.

Caroyln Lawson reported on the outcomes anticipated as a result of delivering the schemes. The ‘Fit to Go List’ referred to patients in the acute area, but whose medical needs had been addressed and were waiting for onward care. The number of West Berkshire patients on the ‘Fit to Go List’ had been consistently low. Regarding the average length of stay, West Berkshire was the best performing authority out of three that the CCG worked with. The capacity of community beds was often filled because this involved teams moving patients into the community sector.

Paragraph 4.2 of Appendix A considered in hours access to primary care, during periods of high demand. The CCG would have offered nearly all of the allocation available.

In hours Accident and Emergency attendance seemed to be reducing when compared to the same period in 2013/14, with a 12% reduction in January 2015 and an 8% reduction overall to date.

A key measure of success was the four hour Accident and Emergency Target. As of February the RBH were just below target achieving 94.7%, which was a sign this was improving. This figure was also more positive when compared to the national average.

Carolyn Lawson reported that in 2015/16, monies would be allocated early enough to come into the CCG’s baseline budgets. Therefore this could be used to recruit permanent staff. This was well received by the Health and Wellbeing Board.

Councillor Marcus Franks asked if it would be possible to address bank holiday and weekend pressures with the new plans. Tandra Forster reported that seven day work was a key national condition and would be covered in more detail under the Better Care Fund discussions.

Adrian Barker thanked Carolyn Lawson for her report and commended the good news story. He understood that the health and social care economy was made up of various providers and queried if the voluntary sector had been involved. Carolyn Lawson confirmed that the voluntary sector had been involved particularly the Red Cross. There was also a Partnership Development Fund of £50k that voluntary sector organisations would be able to bid for in 2015/16.

Adrian Barker also noted that £100k had been allocated to the Alamac system, which he felt seemed a lot of money for a dashboard. Carolyn Lawson reported that not all of the £100k had been spent on this and it  had also included intensive support from the company to aid the recovery process. The cost would not be as high going forward.

Adrian Barker queried what the abbreviations ANP and TTO stood for and Carolyn Lawson confirmed that ANP stood for ‘advanced nurse practitioner’ and TTO stood ‘to take out’ in relation to drugs.

Dr Barbara Barrie welcomed the fact that money would be made available earlier in the year.