Agenda item

The following were in attendance:

Herefordshire and Worcestershire Clinical Commissioning Group (CCG)

Mari Gay, Managing Director

Worcestershire Health and Care Trust (Health and Care Trust)

Matthew Hall, Chief Operating Officer

Sue Harris, Director of Strategy and Partnerships

Mari Gay, the CCG Managing Director summarised the new ‘NHS 111 First’ national programme which was designed to help the NHS manage urgent care and COVID pressures, and inappropriate use of walk-in Emergency Departments. Worcestershire was one of the earliest adopters of this programme, which was designed to encourage people to contact their GP in the first instance or to contact 111. NHS 111 was now able to book directly with GPs, Minor Injuries Units (MIUs) as well as Emergency Departments (EDs).  A Care Navigator would also now be present at the front door of EDs, not to turn people away but to educate them in more appropriate ways to access care in future.

The direct booking process was currently being trialled, with positive feedback and it was emphasised that no one being turned away. The programme was due to be rolled out across the country in November.

The Chairman invited questions and the following main points were made:

·       The Chairman referred to the second stakeholder briefing (appendix 2) and sought clarification that the new programme was not suggesting that calls to 999 may go via 111 and that the main message was to encourage people to ring 111 first if this was the sensible route. The CCG representative emphasised that the programme was not to discourage people from using 999 when needed and that the 999 function for emergencies would continue as normal.

·       The Chairman asked whether the NHS 111 service may be affected by the impact of losing students and was advised that this was a key risk to the programme because the service had also had to support COVID advice to patients –concerns about what would happen once the rest of the region was using the new 111 programme had been highlighted, and was being reviewed urgently by regional commissioners.

·       A member pointed out that he had heard of a resident being directed to Sandwell Hospital, which the CCG representative would follow up as this should not be the case.

·       A member asked whether waiting lists for children’s autism had increased due to COVID as she was aware they had previously been 10 months which was unacceptable, and the Health and Care Trust representatives advised that waiting times for umbrella appointments had generally remained the same, but that two more paediatricians were being brought in to help reduce waiting times. An update on this would go to the Council’s Children and Families Overview and Scrutiny Panel in November.

·       The Chairman queried the advice contained in the second stakeholder briefing (appendix 2) about people arriving at Emergency Departments without an allocated time slot possibly experiencing longer waits, and the CCG representative clarified that the programme was to tackle people who did not need A&E care, for example it was common for people to go there with an ear infection when they could and should access Primary Care.

·       The Vice-Chairman stressed the need to educate the public, which would be very difficult and use of example scenarios would be helpful. The CCG representative agreed that changing behaviour would be challenging but that there would be a high level national campaign and the role of care navigators would also help. While no one would be turned away the care navigators would be able to book in patients with the GP or MIU. Walk-in facilities were not available in all countries, and they needed to be manageable.

Summing up, the Chairman agreed that changing behaviour would be a challenge, although it was hoped that the public would respond better to the new campaign and be educated by the new care navigators at Emergency Departments.