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Health Overview and Scrutiny Round-up

Meeting: 05/07/2018 - Health Overview and Scrutiny Committee (Item 886)

886 Evaluation of Winter Pressures on Urgent Care pdf icon PDF 80 KB

Additional documents:


In attendance for this item were:


Worcestershire Clinical Commissioning Groups: Mari Gay, Chief Operating Officer and Lisa Levy, Chief Nurse/Director of Quality


Worcestershire Acute Hospitals NHS Trust: Michelle McKay, Chief Executive and Inese Robotham, Interim chief Operating Officer


Worcestershire County Council: Avril Wilson, Interim Director of Adult Services and Frances Howie, Director of Public Health


West Midlands Ambulance Service: Mark Docherty, Director of Clinical Commissioning & Service Development/Executive Nurse


Worcestershire Health & Care NHS Trust: Sue Harris, Director of Strategy and Partnerships and Melanie Roberts, Deputy Lead for Community Service Delivery Unit


The Chairman set out the context for the update on winter evaluation work, which had been requested in response to the HOSC's concern about the need for significant improvement in the Acute Hospital Trust's performance and capacity.


A presentation on Worcestershire Urgent Care and Patient Flow had been circulated before the meeting (available on the Council's website here ), which focused on the evaluation of winter 2017/18 and preparing for winter 2018/19.


The Chief Executive of Worcestershire Acute Hospitals Trust (WAHT) talked through the presentation, which included health partners' preparation for winter 2017/18, specific winter schemes, outcomes and overall evaluation. Planning had started in May 2017, with governance via the A&E Delivery Board, and based on best practice and analysis of previous winter pressures.


Specific winter schemes had included focus on:

·         reducing avoidable hospital attendances

·         reducing demand in A&E by enhancing alternative assessment areas within WAHT

·         creating sufficient inpatient and community capacity

·         focusing on best practice discharge processes and revised discharge to assess processes from hospital to nursing homes

·         collaborative work to increase system control with a local 'winter room'


One of the challenges of winter months was the change in patient cohort, which meant more patients with complex discharge circumstances.


Winter evaluation work had been completed by Midlands and Lancashire Commissioning Unit on various aspects of the winter plan, and NHSE had also commissioned a system-wide analysis of the urgent care and patient flow system by a consultancy group (Carnall Ferrar).


Using the evaluation work, planning for winter 2018/19 had already started and was focusing on:

·         preventing demand for acute based services – through increased immunisation for the health and social care workforce and older people (against flu, also pneumococcal immunisation for older people), as well as prevention of urinary tract infections and falls

·         maximising the new services/contracts across the system –extended hours at the Frailty Assessment Unit, new primary care contract and new neighbourhood teams, plus an Urgent Treatment Centre at the Alexandra Hospital (the Alex)

·         matching predicted demand and capacity – utilising demand and capacity tools, building work for redesign of acute beds at Worcestershire Royal Hospital (WRH), also a system-wide urgent care and patient flow system reset

·         further enhancing public and stakeholder awareness – around choices for urgent care, focus on maintaining independence in the elderly and building on a one-system communication plan for staff


The challenges for 2018/19 were completion of building works on WRH  ...  view the full minutes text for item 886