Chris Morley (NHS Devon ICB), Rachel O’Connor (UHP) and Ian Lightley (Livewell Southwest) delivered the Urgent and Emergency Care 'One Plan' & Winter Preparedness report and discussed:

a)    The report presented an update on the progress of the Urgent and Emergency Care 'One Plan', which had previously been presented to the Panel;

b)    The plan was a collaborate strategy between multi-agency partners, drawing together detailed analysis of anticipated demand and capacity modelling from previous year’s performance;

c)    The plan was comprised of:

                      i.    A clear communication strategy;

                     ii.    The seasonal vaccination strategy;

                    iii.    A targeted approach to ‘home first’ delivery for hospital discharge;

                    iv.    A collaborative approach to local demand/capacity escalation;

d)    The most acute pressures were often experienced in the Emergency Department (ED). It was essential to ensure flow was maintained;

e)    This year had presented a challenging winter period for demand and capacity. All hospitals in Devon had experienced significant periods of pressure however, due to sufficient planning and protocol, Devon was able to quickly reduce pressures and return to normal;

f)     Significant progress had been made at UHP this year, particularly in reducing ambulance handover times and meeting the four hour A&E target;

g)    Vaccine uptake had been lower this year than in previous years, and was likely due to an increase in vaccination fatigue. Investigations were ongoing between Public Health and partners to understand more;

h)    There had been a positive uptrend in patients being discharged directly home, increasing to 55% this year in comparison to 23% last year. The target for next year would be 75%;

i)     Innovation was being utilised to increase capacity and support care in the community, including the commissioning of the mobile X-ray car;

j)     Due to recruitment challenges, not all 64 Community Frailty Virtual Ward beds had been opened. The beds were currently operating at 97% occupancy, and would be expanded to 67 beds by 24 February 2025, and 84 beds by 31 March 2025;

k)    The Expanded End of Life Care Team were fully staffed, and supported an average of 31 patients per month move from ED to Mount Gould Hospital, or their home setting. Mount Gould now had 8;

l)     The ‘timely discharge’ focus was performing well, with an additional 60 patients per month being discharged directly home on the ‘home first’ pathway;

m)  UHP demonstrated improvement on all key performance metrics in comparison to last year;

n)    It was recognised that there was further improvement required to the six and eight hour ambulance handover waiting times however, UHP was the fourth most improved provider nationally. 

In response to questions, the Panel discussed:

o)    Recognition of the significant improvement in performance since last year;

p)    The implications of low vaccine uptake, as well as its prevalence across staff, patients and care-givers;

q)    Improvements to ambulance handover delays and ongoing work still required;

r)    Targeting of the X-ray car towards vulnerable and/or disabled demographics who would have otherwise presented at ED with suspected fractures.

The Panel agreed to:

1.    Thank presenters for their ongoing work, and for their regular attendance at scrutiny over the past year;

2.    Note the report.