Report of the Integrated Care System (ICS)
The Accountable Officer and Transformation Manager, CCG presented a report and performance dashboard to provide an overview of CCG performance against key constitutional standards and targets.The report updated committee on referral to treatment times, diagnostic test waiting times, cancer waits, accident and emergency provider and general practice.
The Accountable Officer advised that the high level of infections and staff absence across the winter months of late 2021 and early 2022 had been a particular challenge. He indicated that many of the targets on the dashboard were not being hit and were showing as a red rating.
Members were advised that there was an increase in numbers of people in hospital with Covid, over 8,000 in hospital in March 2022 which was a 20% increase since February 2022. In many cases Covid was not the reason for admission, many were testing positive after being hospitalised with a different condition. The high Covid numbers in hospitals had put significant pressure on the recovery programme.
Committee noted the following comments and responses to questions:
· Concern was raised about monitoring Covid cases once restrictions were lifted. Members were advised that during the pandemic only 1 in 6 lateral flow tests (LFT) had been reported, indicating that only a proportion of positive cases were reported. It was confirmed that the Office for National Statistics (ONS) data across the Country showed that 1 in 25 people were testing positive and data gathered would also show any new variants.
· Covid was considered endemic, there were still high numbers, but the population would need to follow Government guidance on ‘Living with Covid’.
· Concerns were highlighted about breast cancer; histopathology testing and diagnostic waits which were longer than desired. There were also issues for rectal and skin diagnostic waits. Staffing was identified as a big problemwhich could not be resolved by additional funding, there were just not enough trained clinicians to carry out diagnostic tests and procedures in certain specialisms; and there was a shortage of trained clinicians to recruit. The Chairman advised that workforce issues would be looked at in the work programme for 2022-23.
· Members were concerned that it would take years not months to work through the backlog lists and address staffing resources. Members were re-assured that CCG was making some progress to reduce the backlog, but people were still presenting to add to the list.
· CCG was mindful that the consequences go far beyond the dashboard rating, this was about real people with real lives that were being affected by the long wait times and whilst dealing daily with the symptoms of their condition.
· CCG indicated that although changes were being made to areas of the pathway, when a redesign could make a difference, this was not going to resolve the bigger issues.
· CCG advised that it would take a long time to train people in clinical roles, and with more people were leaving the NHS than were joining it there was a need to retain people and make the NHS a place where people wanted to work. It was stressed that the last two years had been exhausting for the workforce and the challenge was not just about recovering elective timelines, but that the workforce needed time to recover as well.
· Members highlighted the importance of learning from good practice and the need to look at the six areas to identify where recovery had gone well so that good practice and learning could be shared across the system and with neighbouring ICS colleagues.
· The Chairman thanked all staff in the system for all the work they do.
The Chairman welcomed the detail in the report and presentation and indicated that key themes of concern from residents were access to GP surgeries and the backlog of elective surgeries. He clarified that committee maintained regular overview of the Primary Care Access Plan and also that a report on the backlog of elective surgeries was scheduled to committee in the work programme.
1) that Committee note the report and request a further monitoring report to a future meeting.