Report of the Head of Adult Commissioning and Health; and the Director of Strategy, NEW Devon and South Devon and Torbay CCGs (ACH/19/98), attached
(Councillor Leadbetter attended in accordance with Standing Order 25 (1) and spoke to this item at the invitation of the Committee)
The Committee received and noted the Joint Report of the Head of Adult Commissioning and Health (Devon County Council) and Director of Strategy (South Devon and Torbay CCG and NEW Devon CCG) (ACH/19/98) on activity and performance across the wider health and care system based on performance data as at November 2018 (Month 8), including later data where available. The analysis and performance commentary focussed on a range of measures covering acute and community hospital settings, primary care and social care selected by system leaders to provide Members with a whole system view.
Members discussion points/comments with the Cabinet Member for Adult Social Care and Health Services, the Chief Officer for Adult Care and Health Services, the Head of Adult Care Commissioning and Health, Director of Strategy (South Devon and Torbay CCG and NEW Devon CCG) and Associate Director of Commissioning (Devon CCGs) included:
· future performance reports would be less process driven and more needs/outcome focussed;
· the Devon winter plan had been reviewed by NHS England (NHSE) and initial feedback had been received by the Clinical Commissioning Group (CCG); and the key areas within the plan included improved patient flow, maximising capacity across the health and care system and preventing avoidable delays that may reduce the quality of care;
· work by the multi-disciplinary A and E Delivery Board which had included a focus on ambulance handover processes with significant improvements;
· data relating to urgent and emergency care NHS 111 and 999 calls and the proportions and numbers leading to emergency admissions; and more information was requested on response times, use of NHS ‘apps’, and new method of recording by SWAST;
· delayed Transfers of Care (DToC) and pressures within Exeter RD&E and Torbay and South Devon, mitigated by short term intervention and re-ablement; and on ongoing analysis to identify the reasons for the increasing numbers;
· analysis in terms of the increasing delays in treatments at the RD&E where other key indicators appeared to be positive;
· the increase in the number of unfilled packages of care and contingency arrangements in place;
· ongoing work force challenges across the health and adult social care, and initiatives to recruit and retain staff which was essential in ensuring consistency, experience and overall capacity;
· the contribution of the Improved Better Care Fund in terms of Delayed Transfer of Care rates; and
· cooperative working between the four acute hospitals.
It was MOVED by Councillor Wright, SECONDED by Councillor Randall Johnson and
(a) that the care staff across health and social care be congratulated in meeting the challenges in difficult circumstances in relation to the reported increases in the (i) Delayed Transfer of Care rates, (ii) the unallocated care packages and (iii) waits for treatment; and the uncertainties created by Brexit and shortages of nursing staff especially in residential care homes; and
(b) that this Committee notes that future performance reports will address the above issues (including additional information as outlined) with a focus on outcomes achieved and progress in relation to the requirements of the NHS Constitution (which sets out rights for patients, public and staff).