Agenda item

Systems Pressures Update

The Integrated Care Board will provide the Commission with an update on System Pressures.

Minutes:

The Integrated Care Board (ICB) gave a verbal update to the Commission on System Pressures. It was noted that:

 

  • The City had faced a Quademic, particularly in children and elderly patients. With high numbers of the common cold, flu, covid pressures and norovirus.
  • The data demonstrated that all Health Care settings had been under pressure.
  • A knock-on effect and additional pressures were faced due to the flooding and this had put a strain on the Ambulance Service.
  • Additional services had been put into place to support the winter pressures. This included:

-      Extra appointments in primary care.

-      Increased opening hours of urgent treatment centres and increased number of available appointments.

-      Ambulances taking patients to A&E and same day emergency care, enabling patients to be seen by the correct service without waiting in the emergency department.

-      The Same Day Emergency Frailty Service was now live.

-      Work had taken place with Derbyshire Health United to help manage the ambulance stack for category 3 and 4 calls, to manage them with a different disposition.

-      Increases to the number of community hospital beds.

-      Working with colleagues to try and promote the vaccination service. Low levels of uptake had added to the overall pressures with more patients in hospital with respiratory and viral infections that could have been prevented, had they been vaccinated.

-      The Respiratory Syncytial Virus (RSV) vaccination programme had been launched for patients over 75 this year. It’s hard to see the data at this stage, however, it is hopeful this will help ease pressures going forward.

  • Plans were currently under way to help support the NHS through next winters pressures and to reduce overall waiting times across the service.

 

As part of discussions following the update it was noted that:

  • An additional clinical navigation system was in place for 111 calls to make sure patients get in the right disposition and reviews were in place to ensure calls were getting to the right place, at the right time.
  • From a General Practice point of view, all GPs as part of the post graduate qualification have to train in paediatrics either through hospital training or through their general practice training.
  • The Merlin Vaz and Oadby Walk-In Centre are both available for walk in patients. When at full capacity, patients are booked in to those centres and are streaming away from A&E. On occasion when they are full, they may temporally stop walk in patients.
  • The Central Access point was now in place for all patients across Leicester, Leicestershire and Rutland (LLR) seeking Mental Health support. Patients can phone the line and get immediate help either on the phone, face to face or if they are known to the service the can go straight in to existing services they have previously attended. Very few waits had been observed in LLRs, compared to regional colleagues. LLR have one of the lowest rates of patients who wait a significant amount of time in Health Services for support because of the pathways that are in place.
  • The flu season had peaked, and the trust was now experiencing a decline in cases. However, from a respiratory virus perspective, the situation remained uncertain. The trust continued to face extreme pressure during this time of year, with additional measures in place to mitigate the impact while actively exploring further actions to support services. Rapid evaluations were taking place on pressures put in place this year to see what had been the most productive. The trust had a strong feeling on what those are and are using that to put in place the plan for next year.
  • The work done to manage the ambulance stack had positive effects that were noticed. There was still room for improvement, but it supported challenges and reduced conveyances on patients going into A&E.
  • Work was still needed to optimize ambulance turnaround times, ensuring that handovers are completed within a maximum of 45 minutes so ambulances can return to service promptly. A new initiative, Leicester 90, was being explored to ensure safe and efficient patient drop-offs and handovers. Learning from neighbouring cities, the focus was not only on the handover process but also on improving patient flow through the hospital. Measures were being put in place to facilitate smooth transitions, aiming for rapid handovers at a rate of three to four patients per hour. This would help ensure timely assessments while addressing essential patient needs such as pressure relief, access to toilets, and nutritional support. Interventions were in place to support these improvements.

 

 

AGREED:

·       Members thanked the NHS for the update and note the report.

·       That data on 111 patients to be circulated to Members.

·       An in-depth report into the Leicestershire Partnership Trust Mental Health Services to be added to the Work Programme.