· Winter Planning and the Covid Response - A verbal update on will be provided by Neil Macdonald, Chief Executive, Buckinghamshire Healthcare NHS Trust and Gill Quinton, Corporate Director, Adults, Health and Housing, Buckinghamshire Council.
· The Covid Vaccination Roll Out Plans and how the Health and Wellbeing Board can Support -A verbal update will be provided by Robert Majilton, Deputy Chief (Accountable) Officer, Buckinghamshire Clinical Commissioning Group (CCG); Louise Smith, Interim Director Primary Care and Transformation, Buckinghamshire CCG; and Richard Barker, Corporate Director, Communities, Buckinghamshire Council.
· Health and Care Survey – to be presented by David Williams, Director of Strategy, Buckinghamshire Healthcare NHS Trust. The report provides an analysis of a community survey into health and care services in Buckinghamshire which the HWB Board endorsed at its meeting in July 2020. The analysis will be used to inform the future development of services.
Recommendation: The Health and Well-Being Board is asked to note the analysis of a community survey which will be used to shape the development of health and social care services in Buckinghamshire. The Board is asked to note further work in focus groups and one to one interviews during December 2020 to provide additional engagement especially from BAME communities and disadvantaged groups.
David Williams, Director of Strategy, BHT, reported that the hospitals were at the peak of the second wave in terms of admissions; there were 65% of the number of cases seen at the peak of the first wave which was resulting in pressures on bed capacity as Covid-19 patients had to be kept separate in the hospital and in intensive care. Some wards had been closed due to Covid-19 outbreaks but routine patients were still being seen throughout the services. During the first wave, elective surgery and outpatients were ceased but this had not happened during the second wave. 98% of patients with suspected cancer were seen within two weeks of referral and 85% received treatment within 62 days. D Williams stressed that the NHS was open and anyone with symptoms or health concerns should seek support from their GP; acute services would see patients as normal. A separate unit had been opened to reduce the backlog of cataract patients.
Winter plan – Direct appointments were now being made via calls to NHS 111 to direct patients to the most appropriate service and avoid over-crowded waiting rooms; it had been successful and would grow over time. A new same-day emergency care centre had opened next to the A&E unit for patients in need of a multi-disciplinary assessment; this made more space in the A&E department for seriously ill patients. D Williams thanked colleagues across the system that had assisted in getting patients home as quickly as possible. Frontline staff were being tested for Covid-19, using lateral flow tests, in order to identify asymptomatic staff that would then have to isolate.
The following points were raised in discussion:
- In response to being asked how long it would take to reduce the backlog of cataract patients to an acceptable level; D Williams stated that it would take at least 6-12 months and that it was critical to keep the Covid-19 infection rate down to avoid ceasing routine surgery.
- D Williams confirmed that anyone who needed an urgent operation would have one; however, the largest areas of awaited surgery were hip and knee replacements.
- The Chairman asked if BHT had extra surge capacity. D Williams stated that there was additional capacity available at Amersham Hospital for rehabilitation but acknowledged that there was only a finite number of beds for acutely ill patients and if Covid-19 numbers rose they would have to look at routine surgery and divert beds and staff to the seriously ill.
Adult Social Care Winter Planning and Winter Resilience - Gill Quinton, Corporate Director, Adults and Health, advised that their role was to support resilience of the whole system, including the acute sector and primary care, by supporting people to live at home, to help avoid hospital admissions and to support people to get home quickly if they were hospitalised. Care homes received a weekly newsletter and were supported with additional personal protective equipment (PPE) and training in the use of PPE. Care homes were provided access to other services including enhanced health support via primary care. The Council set up a process to deliver free PPE, which was distributed via hubs across the county but care homes could also access PPE by the government portal. Care providers regularly tested staff and residents for Covid-19 and the Government was now rolling out lateral flow testing into care homes; five care homes in Buckinghamshire were providing flow testing for visitors. Planning had started on the roll out of the vaccination programme; staff were being prioritised into different categories for access to the vaccine. The Service had supported the rapid discharge programme from hospital and there was a new pathway to discharge into a residential care environment to assess their needs. The Chartridge Service, based in Amersham hospital, was a new service but was not a hospital service. The service provided 15 beds for people, who were still testing positive for Covid-19 but were beyond the infectious period, with a place to recuperate before returning to a residential care home.
The Covid-19 Vaccination Roll Out Plans - Richard Barker, Corporate Director for Communities, provided a presentation (slides 22-29), appended to the minutes, and advised that he was providing local leadership and logistical support in the deployment of the Covid-19 vaccine across Buckinghamshire working with Health and NHS colleagues who were taking the lead on the overall delivery. R Barker emphasised that the rollout of the vaccine was being prioritised for those at greatest risk of harm and that residents should not contact their GP as residents would be contacted in due course regarding their vaccination. Communications would be issued and the NHS would contact residents.
The following points were raised in discussion:
- A member of the board commended the system on the swift set up and asked how the message would be communicated to residents. Martin Tett’s newsletter was consistent and went to approximately 220,000 email addresses but more was needed and it was noted that Healthwatch Bucks and the VCS had a role to play in cascading information. It was confirmed that Kim Parfitt, Head of Communications, Adult Social Care, CCG and ICP would provide co-ordination on the communications when there was a clearer understanding of the delivery arrangements and the supply of the vaccine.
- In response to a query on how less mobile residents would get to the vaccination centres, R Barker stated that the next step was to understand whether any residents would have issues accessing the local fixed sites and whether there were any community transport requirements. It was also confirmed that residents and staff in care homes would receive the vaccine directly in their care home. Katie Higginson added that there was a large pool of capable volunteers available and that she was in discussion with the Council and the CCG to discuss the opportunities to use volunteers.
Health and Care Survey - David Williams stated that a community engagement survey was carried out in July 2020 to find out what was working well and which areas needed improvement. Over 2,800 survey responses were received and D Williams thanked the Council and Healthwatch Bucks colleagues for their support. The majority of responses were from women; 92% were from the white population; more engagement was required from men and the black, Asian and minority ethnic (BAME) community. Phase two of the survey would involve focus groups being held with carers, young people and the BAME community; the results would be presented at the next HWB meeting. The survey had shown that many people were receptive to messages regarding health promotion and life choices and found digital appointments more convenient. However, it was recognised that patients also needed face to face appointments. Patients were asked whether they were willing to travel for one off appointments or treatments and feedback showed that an earlier appointment was more important than distance. Two thirds of residents would prefer to complete recovery at home through support
RESOLVED: The Health and Well-Being Board NOTED the analysis of the community survey which would be used to shape the development of health and social care services in Buckinghamshire. The Board NOTED further work in focus groups and one to one interviews during December 2020 to provide additional engagement especially from BAME communities and disadvantaged groups.
ACTION: D Williams to report back at the next meeting.