Agenda item

The University Hospitals of Leicester submits a report to appraise the Public Health and Health Integration Scrutiny Commission on the current pressures faced across the urgent and emergency care pathway.

The Chair highlighted that the Commission had welcomed the improvements reported at previous meetings and that some Members attended the recent Joint Leicester, Leicestershire and Rutland Health Scrutiny meeting where the issue was discussed but made reference to two recent articles surrounding the number of patients waiting more than 24 hours in A&E and the dire state of local healthcare services.

The Chief Operating Officer at UHL presented the item and it was noted that:

·       There have been improvements to services, but some patients have waited too long for planned and urgent pathways. This was recognised to not be acceptable and continues to be a motivator to improve.

·       Waiting lists increased by the largest amount during the pandemic and UHL was placed in Tier 1 in 2023 but progress has been made and moved to Tier 2 for cancer and planned care and out of tiering for urgent emergency care.

·       There had been a 60% reduction for patients waiting over 62 days for planned cancer treatment and a 77% reduction in waiting lists for elective care. Waiting lists remain long but improvements can be seen.

·       Urgent and emergency care performance was significant improved compared with 2022 but pressures were visible with increased attendance at the emergency department. A system approach has been undertaken to alter capacity and control the flow of patients to ensure patients are being seen at the right place at the right time.

·       More patients are being discharged than in 2022 but people are waiting longer to be admitted which has impacted East Midlands Ambulance Services. The intention is to ensure ambulances can respond to calls as soon as possible but performance has been better than 2022.

In response to Members comments and questions, it was noted that:

·       Patients medically ready but awaiting care arrangements to be discharged was higher on the day of the meeting but generally in the city is between 10-20 on any given day. This often peaks where patients have complex needs.

·       Virtual wards have received positive feedback and are looking to be expanded where appropriate. It was agreed that a briefing session could be arranged to discuss the process and mitigation of risks with Members.

·       Targets are set to improve performance and progress has been made but health is central to people’s lives and the intention is to continuously improve to do better.

·       Health Care Assistants are valued for their role and clarity would be shared with the Commission regarding hold on recruitment.

·       Information would be collected and shared with the Commission regarding deaths resulting from delayed admission or hospital wards.

·       The emergency department continues to be a priority to improve performance and ensure patients are seen by the right person at the right time. 73.9% patients were treated in 4hours and the refurbished facilities enables care to be provided whilst patients are waiting to move to wards. It was agreed that a further report could be shared with the Commission on the emergency department.

AGREED:

·       The Commission noted the report.

·       Briefing session to be arranged on virtual wards.

·       Item to be added to the work programme on processes and targets of the emergency department.