To consider a report that provides an update and overview of performance over the 2018/19 winter period to date across the Leicester City, Leicestershire and Rutland (LLR) Urgent and Emergency Care System.
Mike Ryan, Director of Urgent Care for the Leicester, Leicestershire and Rutland (LLR), Clinical Commissioning Groups (CCGs) and Samantha Leak, Director of Operational Improvement, presented a report that provided an update and overview of performance over the 2018/19 winter period to date across the LLR Urgent and Emergency Care system. Members were asked to note that it was relatively early to report on the winter period and the Director would like to return to the Commission after May 2019 with a report that would provide a more comprehensive picture.
The Director of Urgent Care said that the report set out the over-arching approach on the back of a very challenging winter 2017 / 2018 and a constant resilience was needed as there were surges throughout the year, not just in the winter period. Although the weather this winter had not been severe there had been a rise in demand despite an increase in the work being undertaken to keep people out of hospital.
Members heard that the LRI continued to have the highest number of ambulance conveyances to the hospital (and handovers) in the region. Recently there had been an intense rise in demand from an average of 188 per day to 225 / 230 per day and that level of demand would present challenges for any hospital. The national standard time for an ambulance handover at hospital was within 15 minutes and currently this standard was not being met although performance had improved in February 2019. The Director said that Members would see some significant improvements in the handover time when the report was next brought to the Commission.
It was noted that there were delays in the post-handover time and the reasons for this were questioned. The Director explained that there were new protocols in place relating to patient care and staffing, including time being allowed for ambulance staff to take their breaks. Issues relating to post-handover times were being were being addressed with the East Midlands Ambulance Service (EMAS).
It was noted and welcomed that improvements had been made on information sharing and communications within the organisation and across the system. The Chair said that there was some very good news in the report but questioned whether the system had been really challenged this year as there had not been an outbreak of influenza and the weather had been less severe than in 2017/18.
In response to a query regarding news about the plans to remove the four hour standard for patients to be seen in the Emergency Department (ED), the meeting heard that very few trusts were achieving that standard. The LRI had been put forward to be a part of a pilot scheme to trial a new set of standards.
A Member referred to a recent visit to the Eye Clinic at the ED where she had received very good care, although her experience at the front door and trying to register for the Eye Clinic was unsatisfactory and frustrating. The Director of Operational Improvement thanked the Member for her feedback. She said that when people arrived at the ED, they were often anxious and in pain and that she would take those concerns about the front door and reception back with her.
The Chair drew the discussion to a close and asked the Director of Operational Improvement to come to a future meeting of the Commission should the LRI be chosen to participate in the trial for new ED standards.
1) that the report be noted; and
2) for the Commission to be updated should the Leicester Royal Infirmary be chosen to participate in the trial for the new Emergency Department standards.