Agenda item

Purpose: To present the Dashboard and highlight any emerging issues.

The Board considered Agenda Item 8, concerning the Health and Social Care dashboard, designed to demonstrate system resilience, with the purpose of highlighting any emerging issues. Tandra Forster drew the Board’s attention to the Adult Social Care section and reported that some of the latest data reported had since been updated due to the timing of submission deadlines.

ASC1: Proportion of older people who were still at home 91 days after discharge from hospital to reablement/rehabilitation service: The target was 92% and although performance was reported as 88%, there had been a slight improvement since the data was provided for the dashboard and performance was now at 89%. Tandra Forster explained that the indicator referred to a small cohort of people, this meant that even a small change could impact the ability to meet the target.

(Hilary Cole joined the meeting at 9.09am)

(Councillor Roger Croft joined the meeting at 9.10am)

AS3: Average number of Delayed Transfers of Care which are attributable to social care per 100,000 population (18+): Tandra Forster reported the Delayed Transfers of Care (DToC) information referred to the previous quarter, more recent data showed that performance had improved and this should show in Q3.

(Cathy Winfield joined the meeting at 9.11am)

Tandra Forster advised that nationally, the number of patients attending hospitals was increasing, placing all hospitals under pressure. The Council’s performance with Royal Berkshire Hospital (RBH) was strong,  benefitting from implementation of the Joint Care Provider and seven day working. DToC information showed that there were particular issues with delay at North Hants Hospital.  Analysis of the data highlighted  the  primary reasons for delays were lack of capacity in both homecare and nursing/residential. 

Shairoz Claridge introduced the acute section of the dashboard.

AS1: 4-hour A&E target – total time spent in the A&E department: Shairoz Claridge reported that the figures from October 2015 had been presented to the Board. Performance over the Christmas and New Year period had been better than expected with good patient flow. The year-to-date figure was 95.6%. The Royal Berkshire Hospital (RBH) had achieved the target in the last quarter and efforts were being made to ensure the RBH maintained it.

A remedial action plan was in place to address under performance at North Hants and Great Western Hospital, with Great Western Hospitals NHS Foundation Trust achieving 93.3% against the 95% target. In line with the contractual process, Clinical Commissioning Groups (CCG) were to withhold 2% of the contract value (from December 2015 onwards). Cathy Winfield added that she hoped the impact of the action plan would soon be realised.

AS2: Average number of Delayed Transfers of Care (all delays) per 100,000 population (18+): Shairoz Claridge reiterated that the system was working well. Cathy Winfield commended the system for its performance against this measure and agreed that the issue was being caused by the outsourced parts.

Councillor Hilary Cole enquired how the other hospitals might be brought up to the same level as the Royal Berkshire Hospital and questioned the effectiveness of a fine rather than increased support. Tandra Forster replied that only one hospital had used fines   and discussions were being held to resolve this. She added that if those discussions were not successful, a letter from the Health and Wellbeing Board might be required.

Tandra Forster advised that the delays in general related to a very small cohort of people living in border areas of the district who the local authority struggled to get the appropriate care for. She identified that improvements were needed with North Hants, whose system resilience group was not a strong as West Berkshire’s. Shairoz Claridge added that 40% of Newbury patients were admitted to North Hants hospital but Delayed Transfers of Care was in single figures.

Dr Barbara Barrie enquired whether the matter could be escalated to the Thames Valley level; Tandra Forster replied that the Health and Wellbeing Board could address the issue with the hospital, however the other networks might be helpful.

AS5: Ambulance Clinical Quality – Category A 8 Minute Response Time – Red 2: Shairoz Claridge reported that that performance was green against target for the first time However during September neither the Thames Valley wide nor CCG level standards were achieved.  Performance in September at Thames Valley level deteriorated in Red 1 calls, and improved for Red 2 and Red 19 calls.  The remedial action plan had been agreed with South Central Ambulance Service (SCAS)as a result of the contract performance notice and this forecasted recovery in performance from March onwards. The Trust had started the National Ambulance Response Programme (NARP) pilot in October which allowed SCAS more time to assess Red 2 calls before dispatching an ambulance which should result in emergency ambulances only being dispatched to the most appropriate calls. Following a month of the pilot, SCAS would review the impact on performance and re-profile the trajectory as necessary.

AS6: A&E Attendances: Shairoz Claridge explained that these figures were not RAG rated and since providing the data for the dashboard, the Royal Berkshire Hospital had received 300 further admissions. She reported that the RBH had coped well with these extra admissions.

Shairoz Claridge, in introducing the Primary Care indicators, explained that full delegation would be in place from 1^st April 2016. On-demand General Practitioner (GP) appointments were still a work in progress.

Councillor Roger Croft asked that the fines from North Hampshire be considered at a future meeting of the Board in order to consider a way forward. Councillor Cole agreed that a letter from the Board should be sent to express its concerns.

It was agreed that the Children’s Social Care section would be discussed once Rachael Wardell had joined the meeting.

RESOLVED that

·         the Health and Wellbeing Board noted the dashboard.

·         Tandra Forster to write a letter to be sent to Hampshire Hospital Foundation Trust and to be signed by the Chairman on behalf of the Health Wellbeing Board regarding the fines imposed by north Hants CCG in respect of the DToC target.