Meeting documents

Update on the Buckinghamshire Accountable Care System (Lou Patten)

System Leads will also be providing an update on winter planning under this agenda item.

Presenters:

Ms Lou Patten, Chief Officer, NHS Aylesbury Vale and Chiltern CCGs

Mr Neil Dardis, Chief Executive, Buckinghamshire Healthcare Trust

Ms Gladys Rhodes-White, Interim Service Director, Communities, Health and Adult Social  Care

Mr R Majilton, Deputy Chief Officer, provided an update on the paper and highlighted that there had been a number of visits by national bodies which had provided valuable feedback.   The following areas would be focussed on:

• Population health management – a steering group had been established, led by Public Health, which was very successful.
• The integrated team of Primary and Community Services had been working together to develop community hubs and integrated teams.
• Capacity to deliver; particularly looking at support to ensure the pace and ability would be provided to deliver the system wide work.
• System OD - a programme of work which would look at areas of leadership, system ways of working and culture, and the refresh of planning for 2018/19.

The following questions/comments were raised:

• Ms Baker asked if there was an ACS plan which could be shared with the Board and the public.  Mr Majilton clarified that there was not a specific ACS plan but it was built into the integration and operational plan that was signed off by the Board in March.  The public had been invited to the ACS roadshows.

• Mr G Jackson, Clinical Chair of the Clinical Commissioning Groups and Vice Chair of the Board, said that members of the public had commented that the system was disjointed.  However, as agencies delivering the services were aiming to work together, the public should see a difference in how services were delivered in the future.

The Chairman asked Mr N Dardis, Chief Executive, Buckinghamshire Healthcare Trust (BHT), to provide an update on the A&E waiting time statistics reported on the television that day.

Mr N Dardis said he had never seen such a level of scrutiny and planning for winter and that patients would get the care where and when they needed it.   Mr Dardis reassured the Board and the public that BHT was one of the better performers but they were striving to be better.  The Chairman asked how the performance was in A&E.  Mr Dardis reported that it was worse than it had been but BHT was aiming to improve waiting times.  Mr Dardis added that it was not yet known how much extra NHS funding BHT would receive for the winter preparation.

Ms D Richards, Director of Commissioning and Delivery for the Aylesbury Vale and Chiltern Clinical Commissioning Groups, presented "Winter Planning 2017/18"

as the Chair of the Buckinghamshire A&E Delivery Board.  Ms D Richards highlighted the following:

• It had been a long process since August and plans were being continually developed.
• There was a shared challenge due to increased demand.
• The ACS had undertaken very detailed forecasting for all the services which was updated daily.
• The ACS had mapped service availability for the winter; particularly at Christmas and the New Year period.
• The ACS was pulling together to provide more comprehensive plans and alternatives to A&E.
• Funding had been received from the Urgent and Emergency Care and Transformation Fund to roll out a project in Wycombe, Aylesbury Central and South Bucks to support high intensity users.
• A lot of work had been done on improved discharge planning.
• Beginning to see the benefits of having worked together with the local authority.
• Dr J O’Grady highlighted the flu figures from Australia which provided a forecast for the winter in the UK.  The 2017 flu figures were high compared to previous years; tracking was taking place to monitor peaks.
• A comprehensive flu campaign had been created by the joint Communications team.
• NHS, frontline domiciliary care and County Council Staff had been encouraged to have free flu vaccines.

The following comments were made:

In response to a query on the success of the various winter campaigns in recent years, Ms D Richards said that there had been an increased number of calls to the improved 111 service, resulting in a lower number of visits to hospital. 

• Ms Richards recommended that any member of the public, whether registered with a GP or not, should call the 111 service before they presented themselves at A&E.

RESOLVED:  The Board RECEIVED the report.

The Chairman advised that Mr Dardis would be moving to become Chief Executive of Frimley Health NHS Foundation Trust and that Ms L Patten, Chief Officer, NHS Aylesbury Vale and Chiltern Clinical Commissioning Groups (CCGs) had been asked to cover the Oxfordshire CCG Accountable Officer role on an interim basis, as well as Buckinghamshire.  The Chairman expressed concern over how resilient the ACS system would be due to the loss of Mr Dardis and the increased workload of Ms Patten.

Mr G Jackson clarified that there was work which would bridge Oxfordshire and Buckinghamshire and that the ACS was a mature system.