Issue - meetings

Conor Burke presented the report and drew the Boards attention to the details set out within it.  The Board was reminded that urgent care was fragmented and poor in this area and the Systems Resilience Group (SRG) had been working on the issues for a number of years.  Following a detailed review of attendance and admission data at the SRG April 2016 meeting, a summit was held to address a number of issues and look at what could be done to stabilise performance.  Whilst the urgent care performance overall had been much better in the last 12 months, the most recent A&E 4 hour patient waiting to being seen standard was suggesting a significant improvement to a 92/94% achievement rate.  Data also indicated that there had been a 16% increase in attendance at A&Es.  There was also the ongoing issue of why people attend A&E, when that do not need to be there, and in many instances should be using other community and Primary Care options. 

Cllr Turner commented that this had many parallels with Ambition 2020, including the need to change attitudes.  There was also a need to improve and reflect the other side of services and the health economy, as they interact and impact upon one another.  Cllr Turner reminded all partners about not using jargon in reports, for example paragraph 4.4 of the report. 

Conor explained paragraph 4.4. and agreed that there was indeed a need for a massive change in patients’ behaviour and that initiatives, tried as a result of the junior doctors strike action, had proved successful and would be continued.  It was essential to look at a whole health systems solution and to focus on the Primary Care and community solutions.  Work was being undertaken with Partners in NELFT, the three CCGs, BHRUT and the Council in regards to service provision and in reducing re-admittance rates at A&E.

The Chair raised the issue of the different messages on doctors’ answer phones, which could confuse patients when they were seeking urgent medical help.  Cllr Carpenter also commented that good advice seems to reducing attendance at A&E. 

Sean Wilson, Interim Borough Commander, Metropolitan Police, asked if there was any data behind what had driven the 16% increase in A&E attendance.  Conor responded that there was anecdotal evidence that it was mothers with children attending, however, the 16% increase in A&E attendance in spring this year had not just been local but had been a national phenomenon.

Healthwatch, commented that from their activities it was clear that nobody knows what ‘the hub’ is: even if they were sitting in it.  People are also confused as to where walk-in centres are because they move.  When an appointment cannot be obtained from a patient’s own GP, the hub appointment slots were full, the walk-in in centre was full with a five hour wait or was shut, it was not surprising that people reverted to using A&E: because they know where the  ...  view the full minutes text for item 8