Agenda item

25.1

The report, which provided an update on the ICB (Integrated Care Board) preparations for winter, was presented by Sarah Burt (Assistant Director of Transformation and Delivery, ICB), Michael Harper, (Chief Operating Officer, Sheffield Teaching Hospitals), and StJohn Livesey (Urgent Care Lead, ICB).  A presentation was delivered which was published with the agenda on the Council’s website, as was an update to the midwife retention figures, which had been provided shortly before the meeting.

25.2

Members asked for further information on Respiratory Hubs and were advised that the aim of these was to deal with patients with acute respiratory infections. The Hubs had protected appointments, to avoid that group of patients having to use GP appointments, and also to provide a rapid response which was likely to help them to stay at home.

25.3

Members asked how the problem of delayed discharge from hospital was being dealt with and were advised a discharge programme was in place which contained a variety of schemes which aimed to reduce the number of patients waiting to be released from hospital and have their care handed over to community services. More details on this could be shared with Members if requested.  The ICB collaborated with Health and Social Care on this, e.g. on “Home First”.  Peaks in pressure had been identified so that improvements could be made in how these peaks were responded to.

25.4

In response to a question regarding ambulance response times, Michael Harper advised that regarding queueing times for ambulances, 9/10 patients were being handed over in under 30 minutes. Some issues continued when Accident and Emergency was busy, and patients had to wait for handover.  This could have a knock-on effect on people at home waiting for an ambulance.  A number of schemes had been put in place to tackle this with the aim of releasing ambulances quicker, but there was still work to do.  StJohn Livesey advised that issues with ambulance transfer were symptomatic of wider issues in the Health Service. There had been an expanding need for community care, and a 50% increase in the number of consultants, but no expansion in the number of GPs.  This meant that patients were being admitted to, or staying in, hospital when they should be being looked after in the community. Ambulance transfer issues were a symptom of this.  A review of all urgent care services was ongoing to make community services more robust, and thereby improve the situation in hospital.

25.5

Sarah Burt advised that investment had been made in the voluntary sector, e.g. with Sheffield Churches Council for Community Care, to assist people with transport home and with settling in once there.  Age UK also assisted with this.

25.6

Members asked whether presenters agreed that the risks identified on page 39 of the agenda pack were the key risks.  Michael Harper advised that regarding electronic patient records, the upgrade which would have introduced these had been planned to take place in early October, but it had been deferred. The implementation was now unlikely to take place in winter, so this had reduced the resulting risk.

25.7

Members asked whether additional hygiene measures were being put in place to prevent the spread of infection, in particular following lessons learned during the Covid pandemic.  Michael Harper advised that infection prevention and control was key, and handwashing and cleaning protocols for staff in between seeing patients, remained in place throughout the year.  National guidance, which stated that mask wearing did not have to be universal, was being followed at present.  There was a framework for this, which was dependent on Covid prevalence and that was what advice to staff was based on.  Members asked whether people could be encouraged to wear masks, by the display of appropriate signage.  Michael Harper explained that people with symptoms were encouraged to wear masks, however experience had shown that it was difficult to enforce mask wearing in hospital when it was not being enforced elsewhere.

25.8

The Chair stated that in her view, too much of the learning from the Covid pandemic on mask wearing had been dropped, and the Council and the health service could take more of a lead in fostering a culture of mutual responsibility.  She had also heard that some citizens were too nervous to attend hospital either for their own appointments or to visit relatives. Michael Harper advised that there was a need to be mindful of the clinical evidence, and the risk of wearing versus not wearing masks. The hospital’s policy was led by clinical teams and by national guidance and decisions were made on that basis rather than on individual’s opinions, which were likely to differ. However, he would welcome a debate on this in the city.

25.9

Members asked for further information regarding staff wellbeing.  Michael Harper advised that work was being done on how to support staff health and wellbeing, e.g. to ensure they took breaks.  Investment was being made in core staff, where there was a high demand in a service.  Spaces for staff to take breaks had been retained from the Covid period and regular conversations took place between colleagues and managers.  The organisation was trying hard to develop an empathetic, listening culture, with compassionate leadership.  Health and wellbeing was a key priority, and was monitored over winter, including tracking the reasons for sickness absence and the use of bank staff.

25.10

Members referred to the information on mental health services performance, in the presentation. Sarah Burt advised that work was being done in the city by the Council and Sheffield Health and Social Care Trust, and following significant investment the situation regarding delayed discharge and timely transfers had improved.  There were further improvements to be made, and this was still a work in progress.

25.11

Regarding opening beds, mentioned on page 28 of the agenda pack, Michael Harper confirmed that this was part funded through the Sheffield Teaching Hospitals Budget and part by negotiation with the ICB.

25.12

RESOLVED: that the Sub-Committee notes the contents of the report on the Winter Plan for Urgent Care Services.