- Meeting of Health and Adult Social Care Select Committee, Friday 7th February 2020 9.45 am (Item 9.)
The Committee will hear from representatives from Buckinghamshire Healthcare NHS Trust (BHT) and the Cabinet Member for Health & Wellbeing and Senior Officers from the Council’s Adult Social Care team. This item focuses on the Hospital Trust’s improvement journey (2014-2020) and reviews the achievements and challenges still facing the Trust.
The Committee will also hear about the continuing progress with the development of integrated "home first" model and the formal integration of services with the Council, including Discharge and linking with Community Boards and Primary Care Networks.
Mr D Williams, Director of Strategy and Business Development, BHT
Dr T Kenny, Medical Director, BHT
Lin Hazell, Cabinet Member for Health & Wellbeing
Ms G Quinton, Executive Director, Communities, Health & Adult Social Care, Buckinghamshire County Council
Ms K Jackson, Service Director (Integrated Care), Buckinghamshire County Council
Power point presentation
The Chairman welcomed Dr T Kenny, Medical Director, Buckinghamshire Healthcare NHS Trust, Mr D Williams, Director of Strategy and Business Development, Buckinghamshire Healthcare NHS Trust (BHT), Ms G Quinton, Executive Director, Communities Health & Adult Social Care and Ms K Jackson, Service Director (Integrated Care).
During the presentation, the following main points were made.
· Every year, BHT cares for:
o 600,000 members of the community;
o 460,000 outpatients;
o 100,000 inpatients.
· The latest CQC inspection resulted in BHT being rated as "Good". A number of specific areas of improvement had been identified to help BHT move forward on its journey to being "Outstanding". These areas included safer staffing levels within community inpatients wards and reducing the waiting times for children, young people and families within the community health teams.
· BHT had recently signed the Armed Forces Covenant which highlighted its commitment to local people and staff within Buckinghamshire.
· BHT’s A&E 4-hour performance mirrored the national trend. The Trust had seen a 7% increase in A&E demand over the last few months and was working hard with partners to alleviate pressure on A&E.
· BHT had received funding from NHS Improvement during December to support identified areas of improvement, including additional out of hospital capacity, escalation beds for patients who were medically fit for discharge at Wycombe Hospital and other smaller projects.
· Waiting lists had increased – cancellation of routine activity due to emergency demand had had a negative impact on waiting times. There had been a particular increased demand for ophthalmology.
· BHT was performing above the national average in terms of patients receiving first cancer treatment within 62 days of referral but it remained a challenge due to a number of factors, including higher numbers of patients requiring more complex diagnostics and patients being on multiple tumour pathways. A number of actions had been introduced to help improve the service, including a one-stop clinic for patients, electronic requesting for endoscopy and a new MRI scanner at Wycombe Hospital.
· Six reablement beds had been procured by the County Council to help reduce reablement waiting times.
· Four beds had been procured in a local nursing home to support reducing length of Hospital stay (these were procured until the end of January).
· The County Council’s Adult Social Care team had co-located with teams at Stoke Mandeville, Wycombe, Wexham Park, Amersham, Milton Keynes (2-3 days a week) and Whiteleaf Oxford Health Foundation Trust.
· More patients were being referred to the Community Assessment and Treatment Service (CATS) and there had been an increase in outpatient activity in Thame and Marlow. Amersham was now providing similar services following the temporary closure of Chartridge Ward at Amersham Hospital.
· Continued development of integrated ‘home first’ model to do everything practicable to ensure residents return to or remain in their preferred place of residence.
· BHT’s vision for 2025 and beyond, included the following activities:
o Redesign Urgent and Emergency Care;
o Consolidate Rehabilitation Services;
o Partner in Diagnostics Services;
o Transform Outpatients.
· 61% of practice nurses and 36% of all non-medical staff were over 50.
· The Health & Social Care Academy was working with Universities to attract and train the next generation of health and social care professionals.
· There were a number of ambitions outlined for mental health services, including increasing timely access to mental health services to ensure that people could get the most appropriate help and support at the most appropriate time and the roll-out of a new community mental health framework to help bridge the gap between primary and secondary care services.
· In response to a question about key worker housing, Mr Williams explained that at a recent AVDC Cabinet meeting, it was agreed to use section 106 money to build more affordable housing in the Vale.
· A Member asked whether it would be possible to receive BHT performance data in a dashboard format on a regular basis. It was agreed that BHT would supply this on a quarterly basis.
Action: Buckinghamshire Healthcare NHS Trust
· In response to a question about the extended "silver phone" service, Dr Kenny explained that it was a well-used service where consultants provide support to GPs and paramedics as part of their patient decision-making.
The Chairman thanked the presenters.