Agenda item

Mathew Cole, Director of Public Health, presented the report and drew the Board’s attention to issues set out within the report and appendix and the significant issues that remain in A&E, referral to treatment time, the cancer pathway and unplanned admissions for ambulatory care sensitive conditions.  The discussions included:

Councillor Carpenter drew the Boards attention to page 45 of the agenda and raised concern around the Chlamydia screening targets and achievement rates, which appeared to show both a reduction in target levels and a worsening performance.  Matthew Cole explained that that tests undertaken at GUM clinics are not included in the figures and how the target had changed from the number of positive results to the number of people screened: on that basis we were achieving higher identification rates.  Matthew Cole also reminded the Board that currently the contract is out for procurement.  Testing facilities will also be at all LBBD 50^th Anniversary public events during 2015.

Councillor Worby raised the issue of how the awareness of the young could be increased in regards to the risks of Chlamydia and other sexually transmitted infections (STIs).

Frances Carroll, Healthwatch, drew the Boards attention to page 41 of the agenda and commented that there still appeared to be a considerable level of unprotected sexual activity in under 25s and there were clearly links to this behaviour and the under 18 conception rates and asked what the plans were to target this issue.  Matthew Cole responded significant work had been undertaken on this issue in previous years and that under 18 conception rates, whilst still of concern, had been reducing over the years.

The Chair, Councillor Worby, Cabinet Member for Adult Social Care and Health, raised the issue of the A&E performance.  Dr Nadeem Moghal, Medical Director, BHR Hospitals, recognised that there has been a problem around A&E over the winter pressures and why the targets were important to the treatment and subsequent discharge of patients.  Dr Moghal explained that the Elderly Receiving Unit had now been established and also gave an update on the progress that was being made in regards to ambulatory care team(s).  Consultants were also looking at redesigning the A&E and other systems to improve workflow and patient transitions.  Work was also being undertaken to ensure that the workforce was skills based and not just profession based.

Conor Burke added that the figures had improved since the report was completed in January.  There have been a number of occasions where 97% or 98% of patients had been seen within four hours at King George’s Hospital and 90% to 95% at Queens Hospital and work was continuing to achieve those rates every day.  Discharge rates had also improved and they were now amongst the higher quartile.

Councillor Turner raised the issue of the London Ambulance Service (LAS) and their input to the process and the lack of LAS engagement with this Board.  Conor Burke advised that the LAS do attend the Urgent Care Board.  The LAS was also experiencing recruitment and retention issues, as are many other ambulance services across the country.

The Chair agreed that the LAS should be formerly invited to attend the next meeting of the Board.

The Chair pointed out that health check target was 20%, but currently only 5% is being achieved and asked what was being done to improve on this.  Anne Bristow explained to the Board the actions that were being taken to increase the rate and would gladly receive any suggestions from partners on how the rates could be improved further.  Matthew Cole advised the challenge had been issued to GPs to improve their rate but it should be noted that LBBD are currently achieving higher rates in some areas than many across London and are performing much better than Havering or Redbridge.  Conor Burke agreed to add this issue to the HA improvement Programme.

Jacqui Van Rossum pointed out that the child mental health treatment rates had improved considerably. 

Having received the report, reviewed the overarching dashboard. discussed the performance report for Quarter 3, noted the further detail provided on specific indicators and the new data available, specifically the A&E survey, smoking quitters, Chlamydia screening and NHS Health Check and the actions being taken to sustain or achieve good performance, the Board:

(i)  Noted in particular the:

·  ‘Green shoot’ improvement in A&E performance on a number of days during January and early February 2015.

·  The new Joint Assessment and Discharge Service (JAD) had the resulted in the lowest levels of delayed transfer of care in London.

·  Improvement achieved by the CAHMS service.

(ii)  Agreed to invite the London Ambulance Service (LAS) to attend the next Board meeting to discuss issues affecting their service.

(iii)  Requested Partners to pass any suggestion they had for improving the NHS Health Check rates and Chlamydia awareness and screening to the Director of Public Health.