Chris Morley (Plymouth Locality Director, NHS Devon ICB), Alex Deegan (Primary Care Medical Director, NHS Devon ICB), and Rachel O’Connor (Director for Integrated Care, Partnership & Strategy, UHP) delivered the ‘Winter Preparation and Planning’ report to the Panel, and discussed:

a)    Seasonal variations such as winter planning formed part of the NHS Annual Operating Plan, anticipating and mitigating periods of surging demand;

b)    A ‘Winter Taskforce’ had been established to bring together system partners and utilise previous years learning;

c)    The Communication Strategy was a key component, encouraging healthy lifestyles, vaccination programmes and support available to enable people to remain in their own homes;

d)    Local planning was being undertaken in partnership with Plymouth City Council to increase surge capacity and resilience of care providers in advance of anticipated demand;

e)    The Local Escalation Protocol was being reviewed, allowing timely escalation of individual and system needs/actions when required;

f)     The seasonal vaccination programme for Covid and Flu had commenced in October, and had received positive uptake thus far. There were more GP practices and Pharmacies providing the programme than previous years, increasing accessibility for residents;

g)    Over 18,000 deaths were associated with Flu in England over the past two winters;

h)    Over 80% of those aged over 65 had been vaccinated in the South West last year;

i)     As of 20 October 2024, over 175K Covid vaccines and 250K Flu vaccines had been administered across Devon;

j)     A new vaccination had been introduced for Respiratory Syncytial Virus (RSV);

k)    Information on eligibility and accessibility of vaccinations was available on the NHS website, and individuals were encouraged to engage with the programme to protect themselves, and help mitigate annual system pressures;

l)     There were recognised challenges with access and quality of the Urgent and Emergency Care pathway. In April, a Section 29A notice was from the Care Quality Commission (CQC), largely relating to overcrowding. The UHP ‘One Plan’ had been created in response, to restore high quality care and access;

m)  The One Plan focussed on three key areas: avoiding admissions (maintaining independence), dynamic flow, and onward care;

n)    While September had been a challenging month for the Urgent and Emergency Care pathway, the Trust was now consistently meeting its 4hr standard, and had seen a 30% reduction in ambulance wait hold times. The Trust had now moved from worst performing in the country, to third;

o)    The Plan was backed by a £10 MM investment, including £2MM additional funding from the ICB;

p)    Virtual Ward capacity was being increased, with 125 virtual ward beds being created to support frail individuals on the cusp of hospital admission;

q)    An x-ray car would go live from 30^th October, allowing individuals to receive an x-ray in their own home following falls and suspected fractures;

r)    Same Day Emergency Care staffing and bed capacity had been increased to support quicker same-day treatment;

s)     In a partnership approach, Discharge Pathway One had seen a 120% increase in the number of people supported home.

In response to questions, the Panel discussed:

a)    Annual targets for vaccination programmes;

b)    Outreach events and engagement with schools, homeless communities, and vulnerable groups;

c)    The role of the Joint Committee on Immunisation and Vaccines (JCVI) in advising the timing, eligibility and other factors for all vaccination programmes in England;

d)    The practical operation, strengths and challenges of Virtual Wards;

e)    The potential impacts of national policy changes on the One Plan;

f)     Positive learning from previous years, and a transition away from measures such as the ‘Care Hotel’ towards care in the community and Virtual Wards;

g)    The role of the ‘Surge Plan’ in the event that preventative capacity measures were not sufficient;

h)    Referral methods and accessibility of Virtual Wards and the x-ray car;

i)     Integrated partnership oversight of the Plan, including a weekly progress meeting and monthly monitoring meeting.

The Panel agreed:

1.    To request further information regarding the annual targets for Flu and Covid vaccination uptake;

2.    To add the ‘delivery performance of the Urgent and Emergency Care One Plan’ to the work programme for future consideration;

3.    To note the report.