Agenda item


The Director of Urgent and Emergency Care, submits a report that provides an overview of the ongoing work to prepare for the 2018/19 winter period across the Leicester City, Leicestershire and Rutland (LLR) Urgent and Emergency Care system. The Commission is asked to note and comment on the report as it sees fit.


The Commission received a report on ongoing work to prepare for the 2018/19 winter period across the Leicester City, Leicestershire and Rutland (LLR) Urgent and Emergency Care system. The report was presented by Mike Ryan, Director of Urgent Care (LLR Clinical Commissioning Groups (CCGs) and Sue Lock, Accountable Officer (Leicester City CCG). Members were asked to note that a more detailed report with an outline plan would be brought to the Health and Wellbeing Board at their meeting in September. The Chair asked for the winter care plan be brought to the Commission before the start of the winter period and for the more detailed report that was going to the Board,be brought for noting, to the next meeting of the Health and Wellbeing Scrutiny Commission.


Members considered the report and during the ensuring discussion, comments and questions were raised which included the following:


·      The Chair noted that at a previous meeting of the Health and Wellbeing Board when the Winter Care Plan was considered, Sue Lock had stressed the importance of communication. The Chair asked how effective communication could be ensured this time.


·      It was noted that in relation to delayed transfers of care, the number of cases in the city were down and the improving situation was welcomed.  Members heard however, that there were still many patients who could be discharged earlier and a lot of work was taking place to make further improvements.  Members heard that information on the work being undertaken to facilitate an earlier discharge, could be included in the next report. Comments were made that it was also important to discuss patients’ expectations because their experience often plummeted where expectations were not achieved.


·      Concerns were raised that the report referred to effective communication breaking down as the winter pressures increased, though previously Members had been told that communication was good.


·      A Member referred to the flu jab and questioned whether a more pro-active approach could be undertaken to encourage people to have the flu jab earlier rather than later.


·      The introduction of the ‘Red Bag scheme’ was noted and a request was made that this should include both the regular and emergency medication.


·      A Member asked for the CCG to ensure that patients who needed assessments for an ongoing medical condition, would be able to attend a different clinic if it was not possible to have that assessment at their usual clinic. There was concern that medication would be withheld if they could not have an assessment. The meeting heard that practice nurses were trained to carry out certain assessments and most people with a chronic condition would have an Advanced Care Plan as GPs could not be available 365 days of the year. There was also a system for obtaining repeat prescriptions. The Director of Urgent Care said he would want to know if medication was being held because no appointments were available. Members also heard that investment was being made in the Primary Care Hubs and there was capacity there; they would be able to help in such circumstances.


·      A Member referred to the situation where operations had been cancelled due to emergency surgery and comments were made that this was not just an issue in the winter as operations were cancelled at other times of the year. A request was made for further information on this issue.


·      Mention was made of the ‘message in a bottle scheme’ whereby a person’s care plan and list of medication was placed in a bottle and could be easily located by the emergency and social services, where they saw a ‘message in a bottle’ sticker. The Chair said that she would bring this to the attention of the ward councillors.


The Chair drew the discussion to a close and Members agreed the following recommendations.





1)    The Winter Care Plan be brought to the Health and Wellbeing Scrutiny Commission before the commencement of the winter period;


2)    The detailed report on the Winter Care Plan due to be taken to the Health and Wellbeing Board in September be included, for noting, in the agenda for the next meeting of the Health and Wellbeing Scrutiny Commission;


3)    A report on emergency surgery cases and their impact on planned surgery, be brought to a future meeting of the commission;


4)    That a report on Delayed Transfers of Care (DTOC) be brought to a future meeting of the commission to provide a full understanding of the related issues;


5)    That a report on the Winter Care Plan to be brought back to the Commission after the winter period to include the lessons learned; and


6)    That it be recognised that improvements can be made to improve the take-up of flu jabs.

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