The Director of Planning, NHS Shropshire, Telford & Wrekin Clinical Commissioning Group reported that the NHS was currently experiencing unprecedented levels of demand and that It was anticipated that as winter approached pressures would continue. They outlined the work that was underway to develop the delivery of urgent and emergency care within the Borough and improvements made.
Following the update Members asked a number of questions:
The report noted a recruitment drive for 22,000 allied workers to provide same day capacity within primary care. How many of those are in post currently?
The Committee heard that the recruitment drive was underway and had been rolled out to additional areas across the County and that each practice will have the option to recruit or diversify. It was expected that full coverage would be available by the end of March 2022. The Director of Planning advised that they would be happy to provide further information to the Committee following the meeting.
Had the funding been allocated for the implementation of the Winter Plan and required recruitment drives?
The Director for Planning noted that this was a complex issue with many factors that needed to work in tandem. Prior to Covid the improvements put in place would have had a wider impact but Covid had changed the dynamic of gains made. To mitigate it had required future planning to remain ahead of the curve. Changes already made included bringing on extra beds, access to the rapid response team in more areas across the county and direct access to medical and surgical. The Director for Planning recognised the significant challenges presented by workforce and requested the Committees support in speaking to the public regarding accessing services in the correct way.
The report refers to exploring the suitability of Urgent Treatment Centre model locally. Was more being done to promote them within the Community?
The Urgent Treatment Centre's were important to assist in diverting urgent need patients away from A&E to prevent extended delays. There were a number of centres across the County and that 111 directed patients. It was noted that it was a constantly evolving picture under constant review dependent of funding and public behaviour.
How many additional beds were available and how were they funded?
The Local Authorities opened and funded additional beds so partnership working was required. As of the day of the meeting five additional community beds had become available and a further five were expected the following week.
In order to alleviate pressures on 111 & A&E had more funding been made available to primary care?
Across Shropshire, Telford & Wrekin they had invested in a number of schemes to improve primary care and how it was accessed. This had included an assessment of patients attending A&E unnecessarily and identifying which practices they belonged to and reasons behind this. They found that in some cases it had been due to difficulties with the Telephone systems which had resulted in investment to increase capacity in addition to closer working with the practices in question. Funding was also in place to support the discharge process. It was noted that whilst funding had been directed to build capacity within primary care this is just one area to consider. There was existing capacity with Urgent Treatment Centres but greater dialogue with the public was required to get the message across that only minimal A&E attendance is required. They also mentioned further plans to increase the capacity of 111.
The Director for Planning highlighted that a wider whole system approach was required as each area impacts another, citing improvements to discharge which resulted in funding domiciliary beds and other areas.
With Winter Pressures well underway has the coordination of ambulance handovers between the SaTH and WMAS improved?
The Director for Planning noted that the work undertaken by HALO's, paramedics and West Midlands Ambulance Service has been invaluable.
The Executive Director of Nursing and Clinical Commissioning, West Midlands Ambulance Service advised Members that there had been a number of positive meetings but there was no quick fix. There had been no evidence of improvements as of the time of the meeting with many ambulances across Shropshire and Telford & Wrekin stationary outside Princess Royal & Royal Shrewsbury Hospitals. They noted that despite this they were still responding but were reliant on outside ambulances. They spoke about the introduction of a Community Rapid Intervention Service to improve the way category 3 incidents are dealt with and offset other pressures.
What were Members of the JHOSC able to do to support with ongoing system pressures?
Member's using their network and influence amongst the community to help communicate the best ways for the public to access the system.
Members thanked the Director of Planning and asked that they return to discuss the outcomes of the measures that had been outlined in the plan once data was available.