Agenda item

The Panel was provided with a presentation from the Chief Executive of Doncaster NHS CCG and the Chief Operating Officer of Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, which focused on;

•           Winter Planning Context

•           Approach to Winter Planning/Managing Winter

It was reported that there was a well-established system in Doncaster through joint planning undertaken across health and social care involving partners from both the public and private sector.

Members were informed that specific activities had been commissioned although resources could be an issue when planning.  It was explained that there had been a focus on different topics throughout the year using major communication campaigns (including the use of social media).

It was explained that there had been a winter 2018/19 review and evaluation to understand the impact of schemes on the urgent and emergency care system with a demand and capacity analysis for local urgent care system as a whole.

Members were informed about areas being taken forward as the part of the approach to managing winter that included;

•           Established approach to system escalation

•           Planned proactively for Christmas and the New Year period.

•           Commissioned changes.

•           Additional staff and beds plus strengthened processes of DBTH.

•           Use of the LA Winter Pressures Fund

Members were assured that a Doncaster Winter Plan document set to ensure that all actions were aligned and that the urgent care system was sighted on the risks and associated contingencies as a whole.

In terms of continuity, Members were advised that the same grant had been rolled forward from last year.  It was commented that it would be useful to have long term funding within Adult Social Care to be able to plan effectively.   Members were informed that greater investments had been made in independent home care and short stay approaches in care homes to ensure that there was the correct provisions in place.

It was reported that it was a challenging context with unpredictability over the winter period and therefore vital to remain strong to be able to address any future challenges that may arise. 

There was a discussion held and the following issues were raised;

Water born viruses arising from the recent floods within Doncaster – Members were informed that at this time of year there tended to be a rise in cases of norovirus and influenza that generally resulted from the seasonally cold weather.  It was explained that data collected did not always include the causes of such viruses and therefore would be difficult to determine whether a rise in cases would have been due to the recent flooding in Doncaster.   Members were assured that Public Health England would monitor data over that time and investigate any increases arising from geographical data.  A Member commented that groups within emergency services such as the fire service had been effected in the past and recorded statistical information as a result.  It was suggested that this could be considered as part of the recovery work going forward.

Chaperoning people who are elderly or with dementia (needing support) - Members were informed that there was a positive navigation service for patients with dementia within the NHS.  It was outlined that this set out to provide navigation through services through accessing a person to provide support.  In terms of social care, it was considered that more could be achieved and with better coordination for people in certain high dependency groups, however, it was noted that this was a similar story to other areas outside of Doncaster.

It was also explained that work had been undertaken to help improve the skills of staff across the board through a Dementia Specialist Nurse who provided inductions to other staff.  There was also a practice where case studies were reviewed when something had not worked well.

NHS ‘Apps’ – It was stated that there was a NHS ‘app’ that could be downloaded and it was questioned what could be done to install confidence in the public to use this and other modern technology effectively.  A Member raised their concern that the development of an NHS ‘app’ was at the expense of other areas.  Concern was also raised about the ability of those who were elderly or with dementia when using it.  It was commented that new technology provides a range of potential benefits including for example, allowing the individual to view information to help them make real decisions. It was added by the Chief Operating Officer of the Doncaster and Bassetlaw NHS Foundation Trust, that the standards applied in technological and health care had received positive experiences.

The Director of Public Health suggested that this could be a potential topic for a future overview and scrutiny to consider the use of technology in health and social care and how people were not excluded.

Members were informed that although the NHS CCG considered best practice outside of Doncaster, the partnership in place was one of maturity that had become stronger since the new Emergency Care Model had been introduced 4 years ago.  The Director of Adult Health and Wellbeing commented that it was not about being complacent but about understanding the day-to-day challenges.  The Chief Executive of Doncaster NHS CCG commented that the CCG constantly questioned what more could be undertaken to improve what was already in place. 

There was a brief discussion about the increasing demand of those individuals who attended Accident and Emergency Departments (who did not need to be there) and the possible reasons behind it.

It was noted that GP data was not collected nationally, but recognised that there were frustrations with GPs working within Primary Care.

RESOLVED that the Panel note the report and update provided.