Agenda item

The NHS North East London’s Director of Partnership Impact and Delivery for Barking and Dagenham (DPID) introduced a report and presentation on the winter planning preparations across the Barking and Dagenham place-based partnership, which was underpinned by the Barking and Dagenham, Havering and Redbridge (BHR) Places Urgent and Emergency Care (UEC) Improvement Plan.

The Winter Plan for 2023/24 focused on the three core areas of prevention, hospital avoidance and discharge support. Priorities and key actions had been developed through a partnership workshop and would be developed further through the Adults and Children’s Delivery Groups, ensuring it was responsive and dynamic. 

The DPID commented on the additional impact that the cost-of-living crisis was having on the local community and referred to a number of health and equality pilot projects that would help to address some of those issues, which had been incorporated into the Winter Plan.  Another key element of the Winter Plan related to national guidance issued by the Department of Health in July, which set out the responsibilities of ICBs and NHS Trusts in terms of High Intensity Interventions (HII) that covered 10 specific aspects.  It was noted that the ICB actions would be led via the Place Based Partnerships and be amalgamated into the NHS NEL Plan.

A workshop held on 9 August was well attended by partners and discussed opportunities to strengthen the partnership response to winter resilience. The workshop focused on the areas of Right Care First Time, prevention, proactive care and discharge support. Some key themes that came out of the discussion included:

·  Improving the communication channels between providers – strengthening and improving access to a directory of services that enabled practitioners to refer to the full range of out of hospital services;

·  Education and better communication with residents so they know how to access local community services and care for themselves and their families;

·  Early preparation and taking a more proactive approach to planning – engage with residents well ahead of winter so that they feel that they have a stake in what is being offered;

·  Development of a robust response for people presenting with mental health conditions in the community;

·  Optimising current services and pathways e.g. integrated case management, voluntary sector support post discharge; 

·  Improving the discharge process – better understand the reasons for delays for B&D residents and support early discharge planning. 

Stemming from the issues referred to above, the DPID referred to the draft Winter Plan and UEC Improvement Strategy and Plan which were appended to the report, the funding required to support the initiatives for 2023/24 and key risks.  The Committees in Common also heard from NHS NEL officers on a range of communication campaigns aimed at raising residents’ awareness of where and how to access services, changing behaviours

Members very much welcomed the Winter Plan and made a number of observations, which included:

Ø  Taking advantage of Community Hubs, several of which were based in health-related buildings, to deliver a combined health programme and the additional role that Homes and Money Hubs may be able to play;

Ø  The need for accurate and timely intelligence to inform plans and respond to changing circumstances;

Ø  The need to reflect the important role of carers in addressing winter pressures;

Ø  The work being undertaken with GPs and community pharmacists to promote awareness of the services they offer and avoid presentation at UECs;

Ø  The importance of communications not referring to the term “inappropriate attendance” to avoid alienating those who may not have presented themselves at the correct service / location, and instead referring to “alternative options” for patients to receive a quick and appropriate response;

Ø  The need for the 111 non-emergency contact service to be better informed of where individuals should be signposted to;

Ø  The significant role of the Respiratory Service and wellness events in alleviating system pressures;

Ø  The additional pressures likely to arise following the recent closure of the 120-bed Chase View Care Home;

Ø  The use of the Better Care Fund to meet challenges;

Ø  Healthwatch had been commissioned by BHRUT to undertake a review of discharge arrangements, which would be shared with the Committees in Common at a later date;

Ø  The need for robust monitoring of the impact of the Winter Plan and the communications supporting it.

An issue was also raised on whether a communications plan was being developed regarding the latest Covid variant.  The Council’s Director of Public Health advised on the current position and undertook to circulate relevant information to partners.

The Health and Wellbeing Board and ICS Sub-Committee:

(i)  Endorsed the Winter Plan 2023/24 as set out at Appendix 1 to the report and noted that it would be updated to reflect observations made at the meeting and any other relevant factors that may arise; and

(ii)  Approved the Demand and Capacity Investment Plan contained within the Winer Plan 2023/24.