Venue: Ground Floor Committee Room - Loxley House, Station Street, Nottingham, NG2 3NG. View directions
Contact: Jane Garrard, Constitutional Services 0115 8764315 Email: email@example.com
Note: The minutes for this meeting were taken by Nottinghamshire County Council.
Apologies for Absence
Councillor Pauline Allan
Councillor Eunice Campbell
Councillor John Doddy
Councillor Brian Parbutt
Councillor Jacky Williams
Declarations of Interests
To confirm the minutes of the last meeting held on 14 January 2014.
The minutes of the meeting held on 14 January 2014 were confirmed and signed by the Chairman.
Report of the Head of Democratic Services (Nottingham City Council)
Dara Coppel, Unplanned Care Programme Manager from Nottingham City Clinical Commissioning Group provided an update to Members on the work of the board, including how urgent and emergency services in Nottingham have dealt with winter pressures.
There have been a number of sub-groups which have been set up since the last update in September:-
· Local System Resilience Planning Group – To develop plans that help support health and social care services to meet fluctuating service pressures whilst maintaining service quality.
· Primary Care Access Planning Group – To better understand variation in primary care access across South Nottinghamshire and to identify how to best optimise access and reduce demand on A&E.
· Frail Older People Planning Group – To oversee development of services for older people; to improve provision, quality of care, and outcomes for patients across the local population whilst ensuring best value for commissioners.
· Provider Planning Group – To develop and maintain relationships and collaborative working across providers to ensure the safe and timely transfer of patients from NUH into community services.
Underneath all of these sub-groups is the Performance Oversight Planning Group which determines indicators and interface standards to fully understand and monitor changes in performance.
Despite ongoing investments and actions, performance in recent weeks against the 4 hour target standard (patients being seen and discharged within 4 hours) has been poor, but attendance in A & E has mainly remained the same apart from a recent decrease. The number in admissions is also very similar to last year’s figures. The number of admissions of people over the age of 80 is still going up.
To address the recent poor performance, the CCG’s (Clinical Commissioning Groups) are working closely with NUH to implement a recovery plan for both the hospital and community providers who support the urgent care pathway.
To help try and improve the situation a number of developments have been put in place to improve emergency care:-
· Transfer to access – If a patient is medically fit, try to get them transferred to a community care home within 24 hours of being discharged.
· Choice Policy – This is drafted by NUH, this will help the unblocking of beds, and waiting for a care home can take up to several weeks. It explains that medically fit patients have to be placed in an interim care home.
· GP Aspirations – To set standards for all GP practices across South Nottinghamshire
· Recruitment of key staff
· Redirection of patients from ED with primary care needs.
· Enhance and develop ambulatory care pathways.
· Winter Planning (recovery plan) – The two key groups who are responsible for overseeing the implementation of the Recovery Plan and Improvement Plan are the Collaborative Commissioning Congress and the Urgent Care Working Group.
· Walking the walk (the frail elderly persons pathway – getting visits organised (Joint Health Members received and took up this offer in the summer of 2013).
In summary the Care Board is taking good strides but is still struggling to hit 95% target. Transformation agenda will ... view the full minutes text for item 62.
Report of the Vice-Chair of the Joint City and County Health Scrutiny Committee (Nottinghamshire County Council)
Neil Moore introduced the report along with colleagues from Arriva and told the Committee that Arriva Transport Solutions Ltd has been the provider for the NHS Non-Emergency Patient Transport Services in Nottinghamshire for the past 18 months; the contract was awarded in July 2012. The committee were concerned with level of performance which is still short of expectations, but Mr Moore reassured Members that Arriva is a patient focussed company and are committed to making improvements to the efficiency of its service delivery.
Neil Moore with Arriva colleagues made the following points in respect of what is happening at Arriva to help improve the service:-
· We have prepared a service improvement plan and also provided a strategic update which provided details of the steps they wish to take to improve performance.
· A stakeholder group has been formed and has recently met. The intention is that these meetings will provide a forum for feedback and discussion and will hopefully promote performance improvement
· A creation of a post which has recently been filled at the end of 2013 by Tony Attersmith, Head of Service for the East Midlands. A new management system is now in place. Since he has been appointed a number of changes have been made. A new telephony system will be in place from February. A review of rotas has taken place. Promoting the online service so patients can book their appointments via the internet. A review of cancelled and aborted journeys is taking place on a monthly basis.
· 2 operation managers have been recruited, one for the north of the county and one for the south of the county. This allows these posts to enter hospitals on a regular basis and match resources with demand.
· The introduction of more team leaders will provide a good support stream for the staff who work at Arriva.
· Looking at the pre planning escalation process, get information about patients the day before their travel. Pre plan today for tomorrow. Also a phone call in advance on the day of the booking is starting to take place in the north of the county, to make sure the patient is aware of their booking and are ready for our arrival. That would cause re-planning for the whole day if patients are not ready.
Key Performance Indicators (KPI) was laid out within the contract and ATSL was expected to adhere to the standards which are subject to final penalties. In respect of KPI 1, performance has been achieved and maintained throughout the past seventeen months. This contract regarding the KPI’s does not translate into patient experience. Arriva is very dynamic; they can be waiting for a patient for up to half an hour upon arrival, which automatically means we have not reached the KPI performance targets but our priority is to transport patients safely to hospital so that patient does have a good experience with us.
Moving forward for Arriva, continue to engage with units. The relationship between ATSL, commissioners, contract management staff, provider units ... view the full minutes text for item 63.
Report of the Head of Democratic Services (Nottingham City Council)
Members discussed the work programme and agreed that a report on CQC at the NUH for Bereavement and Maternity Unit be added to the work programme for the next meeting. EMAS Volunteer Strategy can also be on the agenda for the next meeting.