Agenda item

Jon Melbourne (Chief Operating Officer, University Hospitals Leicester) and Rachna Vyas (Chief Operating Officer, Integrated Care System) will present and outline the ICB/NHS winter plan and priorities for the 2023/24 winter period. Mayur Patel (Head of Transformation, LLR Integrated Care Board) and Nisha Patel (Head of Transformation, LLR Integrated Care Board) will present an overview of Primary Care Capacity Planning over the winter period.

Jon Melbourne (Chief Operating Officer, University Hospitals Leicester) and

Rachna Vyas (Chief Operating Officer, Integrated Care System) outlined the ICB/NHS winter plan and priorities for the 2023/24 winter period. It was noted from the presentation that:

·         The plan was a system plan and not just a UHL one.

·         The early publication of the national winter plan (in January 2023) was welcomed.

·         The local Winter Plan focussed on the following four areas:-

-       Increased capacity

-       Speeding up discharges from hospital

-       Expanding new community services

-       Helping people to access the correct care.

·         Ways that improvements to flow in and out of hospital were listed as:-

-       Opening Acute Respiratory Illness Hubs in Primary Care.

-       Provision of Virtual Wards.

-       Increasing the same-day emergency care within both Leicester Royal Infirmary (LRI) and Glenfield Hospital (GH).

-       A new Respiratory Ward, Chest Pain Centre and Respiratory Support Unit at GH.

-       The challenge around children and young people has been tackled by including them in the plans from the outset – and increasing the capacity in Paediatrics.

-       By reviewing pathways and increasing community capacity the blocks to discharge have been reduced.

·         There was a strong Elective Care Plan which incorporates protected capacity to reduce waiting lists. Metrics to indicate this waiting list reduction, including the Cancer waiting list, were included in the reports within the agenda pack.

·         Data in the pack highlighted the reduction in ambulance handover times and the reduction in the diagnostic backlog.

·        

Rachna Vyas’s presentation included the points below:-

·         Other impactful programmes included;

-       The Pulmonary Rehabilitation Programme.

-       A Crisis Pathway for clients living in inadequate housing (and this is linked to close liaison working with the Local Authority on Housing issues, damp and mould etc).

-       Unscheduled Care Hubs have representation from all agencies. These can meet the holistic needs of the patient (eg providing handrails for home), increasing flow and easing system pressures.

·         There had been an increase from 500,000 to 600,00 from last year to this for Primary Care appointments - with pathways in place to transfer burdens from GPs to services such as Pharmacy.

·         Ambulance handovers were at 1.5 hours last year.

·         At the last Health & Wellbeing Board (HWB) the Presenting Officer had reported on the 300 patients found to have not had their NHS Health Check; this had since increased and had been a valuable piece of work.

·         The plan had received national recognition for its partnership working – with regional colleagues asking for advice on how Leicester was achieving this.

Comments and questions from the Board:-

-       Members of the Board thanked everyone involved - and noted that this was a great example of progress through partnership.

-       Members of the Board commented that prioritisation and investment in prevention was vital.

-       Members agreed that prevention was not just the responsibility of Public Health - and called for there to be a commitment in the financial element of the ICB 5-year plan.

-       Members asked the presenting officers to comment on whether demand for services and public attitudes had changed since the Covid pandemic. Presenting officers responded that demand had increased because people are generally more poorly post-pandemic.

-       Members asked the presenting officers whether the amount of unnecessary overnight stays had decreased. Presenting officers responded that this was likely to be similar in levels to last year – but did not have the exact data with them in the meeting.

-       Members asked whether the workforce had increased in capacity, and by how much. Presenting officers responded that capacity had grown through the initiatives noted above – and officers were grateful to NHS England for their support with the additional wards.

-       Members asked about involvement/engagement with Staff Unions. Presenting officers responded that industrial action had impacted on reducing waiting lists this year – but noted that there was engagement with Unions about plans.

-       Members noted that there could be merit in using population health information to identify cohorts who we can predict will be high users of health and social care services (eg who is likely to have respiratory illnesses) – and thus target services at those people. This could be done via a Task and Finish Group. Presenting officers responded that there were already adequate partnership groups in place without setting up additional groups – but agreed there was appetite across the system to look at this collectively.

-       Members commented that there was not opportunity to fully utilise the “Core 20 Plus” funding last year to impact health inequalities (other than the setting up of the local fuel poverty programme), so this year that funding could be used to maximise benefits via preventative projects.

-       The Chair was excited by the prospect of collective prevention work, and cited a presentation from a Paediatric Respiratory Specialist which pointed to the differences that can be made to quality of life when a home is made warm and dry.

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-       The Chair noted that people who had a negative experience in the last few years would need support to regain confidence in the system - and have the knowledge to access help at an early stage.

-       Members asked about how the voluntary sector could be part of the solution. Presenting officers responded that for last year’s winter plan they worked with 40 local voluntary groups – and this helped with understanding why some groups did not access services.

[Mayur Patel (Head of Transformation, LLR Integrated Care Board) and Nisha Patel (Head of Transformation, LLR Integrated Care Board) were present to answer queries – but a separate presentation on an overview of Primary Care Capacity Planning over the winter period was deemed to be unnecessary by The Chair as she felt this had been more than adequately covered in the main presentation].

RESOLVED:

1.    That the Board thanked Officers for the presentation and asked them to take Members comments into account.

2.    That the Board will support prioritisation of prevention (resourcing and changing mindsets/culture) via existing partnership groups.

That the Board noted the progress made in the last twelve months.