Agenda and minutes

Apologies for absence were received from Karen Chouhan, Chair Healthwatch Leicester, Professor Azhar Farooqi, Co-Chair Leicester City Clinical Commissioning Group,  Elaine McHale, Interim Strategic Director, Children’s Services, Leicester City Council and David Sharp, Director, (Leicestershire and Lincolnshire Area) NHS England. 

The Chair welcomed everyone to the meeting.  He welcomed Mr E White CC, Chair of Leicestershire County Council’s Health and Wellbeing Board. 

The Chair reminded everyone that the last meeting held on 6 March 2014 had been held to understand the issues of A&E and Urgent Care and to explore the effectiveness of various interventions that had been taken.  It had been agreed to meet again the review the implementation plan and to seek assurances that the plan would be effective as it needed to be.

Members are asked to declare any interests they may have in the business to be discussed at the meeting.

Members were asked to declare any interests they might have in the business to be discussed at the meeting.  No such declarations were made. 

The minutes of the meeting of the Board held on 6 March 2014 are attached and the Board is asked to confirm them as a correct record.

RESOLVED:

That the minutes of the meeting of the Board held on 6 March 2014 be confirmed as a correct record, subject to the start time being amended to 2.00 pm.

Further to the meeting held 6 March 2014 which discussed the Urgent Care/A&E Department arrangements, there will be further discussion on the proposed way forward.  

The following organisations have been invited to attend to contribute to the discussions:-

Leicester City Clinical Commissioning Group

NHS England

University Hospitals of Leicester NHS Trust

Leicestershire Partnership NHS Trust

East Midlands Ambulance Service NHS Trust

Leicester City Council Social Care

Healthwatch Leicester

Mr E White CC, Chairman, Leicestershire County Council Health and Wellbeing Board will attend as an observer.

Cllr Chris Emmett, Chair, Rutland Health and Wellbeing Board has been invited to attend as an observer.

Jane Taylor, Emergency Care Director, Leicester, Leicestershire and Rutland, gave an overview of the actions taken over the last 6 months.  During the overview the following points were made:-

·         The production of the improvement plan was a continually evolving process involving a constant review process by all partners to examine what had worked and what had not.

·         Everyone involved was clear on the key themes of the improvement plan, the level of engagement and the complexity of the actions taken over recent months.

·         There had been an on-going tracking of a set of indicators on a weekly basis over the last 4 weeks.

·         National Standards for Accident and Emergency/Urgent Care systems had recently been published which set out 5 key areas and standards of performance for the following areas:-

o   Demand Management

o   Flows of patients within A&E

o   Hospital Flows

o   Delayed Transfer of Care

o   Wider Governance Issues  

·         The review and planning process had taken place to consider current arrangements against these national standards to see how the services were currently performing and what was needed to be done to achieve each of the national standards in the five key areas.  The Plan was also being aligned to the Better Care Together programme and NHS organisations operational plans.

·         The first draft of the Action Plan, which was being considered at the Trust Board that evening, would give a framework to build upon for what needed to be done.  The detail behind the action plan would evolve over coming months.

 Following questions by Members of the Board it was noted that:-

·           The CCG were supporting UHL in a number of initiatives to help patients to be treated in more appropriate and alternative places than being admitted to acute services at UHL.  These involved:-

o   Proactive case management of patients. E.g the named GP for every patient over 75 years old.

o   Nursing home and housebound patients’ interventions to prevent unnecessary hospital admissions.

o   Management of responses to calls to the ambulance service.

o   Consultant triage process of patients from GP referrals.  This was working well, although it was not an easy task to have a named GP for each patient over 75 years old and to be available at all times for case discussions with the consultant, nor was it easily fundable.

·           There was evolving evidence that public information campaigns for the winter months were more successful when targeted at specific health conditions or communities compared to general campaigns  

·           The previous National Campaign based around ‘Choosing Better’ was being revised locally to encourage patients to seek alternative medical intervention at an early stage rather than leave their condition untreated until it required a hospital admission.  Often patients did not seek early intervention as they did not want to be ‘burden on the system’.  The publicity sought to emphasise that it was not being a burden to seek alternative interventions and reinforced the message that it was better to seek treatment early than leave it until the condition reached  ...  view the full minutes text for item 78.

The Chair declared the meeting closed at 12.44 pm.