Agenda item

Report of the Staffordshire and Stoke-on-Trent ICB.

Phil Smith, Chief Delivery Officer presented the System Pressures to the Committee. It was reported that the Staffordshire and Stoke-on-Trent ICS developed a full system winter plan to manage winter 2022/23 however the position in Staffordshire was challenged with high levels of pressure and cumulative factors contributed to the system declaring a Critical Incident from 29 December 2022 to 12 January 2023. It was reported that there were three key components which exacerbated pressure:

·         Workforce

·         Demand

·         Supply

The Committee were informed that the ICB agreed that a priority action would be to carry out a thorough assessment and review of the plans effectiveness in March 2023 and a lessons learned workshop event was held with all constituent system partner organisations. The key themes covered by the event were:

·         Winter Plan Development Process and Delivery;

·         Workforce and recruitment;

·         System Escalation Planning and Clinical Risk Sharing;

·         System Critical Incident & Early Warning signs;

·         Test adherence to the ICS Leadership Compact;

·         Finance – 2022/23 allocation and spend & anticipated 2023/24 funding;

·         2023/24 opportunities

The Committee were advised that the Urgent and Emergency Care Improvement Plan had been agreed. The Committee were updated on current performance of 111, Ambulance Activity, ED Activity, Medically Fit for Discharge and Discharge pathways.

The Committee noted the following comments and responses to questions:

·         The voluntary sector was crucial to support people to stay in their own homes and assist in discharges from hospital. The ICB was working with voluntary sector to provide this support.

·         Urgent treatment centres would play a role moving forwards and the designation of these centres would need to be agreed by the ICB at the end of 2023/24.

·         The Workforce Staff mobilisation process had been in place since COVID to encourage staff to move to the areas of highest need. There was now a People Hub to replace this and include social care provision.

·         Prevention for the Frail and Elderly, particularly around care homes was discussed. A high proportion of ED admissions and end of life were from care homes and preventative community-based services such as the Fire and Rescue Service providing a falls service and GPs in care homes were being considered.

·         In developing the winter plan, the UHNM, UHDB and RWT were engaged for residents who were treated out of county.

·         The reablement offer should be consistent throughout the County and re-admissions to hospital were monitored.

·         There had been an improvement for community rapid intervention service, designed for the emergency response patients. 111 and Ambulance services had signposted to the service to prevent hospital admissions.

·         In Q1 there had been improvements in 4-hour A&E performance. Ambulance response times were closely monitored by the ICB. In the most recent data, it was reported that Category 2 response times in the County were adhering to the national target of 30 minutes.

·         It was reported that more rural areas may see longer ambulance response times. The Committee were informed that these variations were monitored, and a breakdown of the category 2 response times would be shared with the Committee.

·         The Committee requested to receive the full plan before winter 2023/24.

Resolved – That (a) the system pressures update for the Staffordshire and Stoke-on-Trent Integrated Care System population be noted.

(b) a breakdown of the Category 2 ambulance response times be shared with the Committee.

(c) the full Winter Plan 2023/24 be brought to Committee before Winter 2023/24.