The panel to receive a report on urgent care including NHS111 and the Accident and Emergency Plan.

Elaine Fitzsimmons and Sharon Matson from NEW Devon CCG provided the Panel with a report.  It was reported that -

a)    all emergency departments have a 4 hour target. The emergency department at Derriford Hospital in quarter 1 and the impact of the cold winter meant that patients were waiting longer than 4 hours.  There were three overarching causes which led to the Emergency Department not delivering,

b)    the demand for emergency care had not gone up but mix of people presenting at hospital had changed.  People were a lot more unwell and needed to stay at Derriford hospital longer which had led to a backlog;

c)    they were required to produce an improvement plan on what they expect from Derriford hospital over the next couple of months.  They would monitor the plan twice a month on how the services were responding.  Performance was improving and there were robust continuity plans in place to avoid escalation.

In response to questions raised, it was reported that -

d)    the action plan timescale to be achieved by the end of Quarter 1 in September and they would provide an update to the Panel in November;

e)    work was taking place on how to appropriately deal with patients coming into the emergency department with additional needs such as dementia;

f)     the action plan would cover all the elements of the urgent care system, on how they commission, communicate with the public and ensure better links between services.  The plan focuses on the 4 hour proxy indicator and there were other indictors that focused on wider care.

A report was provided to the Panel on NHS111 and it was reported that -

g)    the South West Ambulance Trust (SWAST) would run this service with the advantage of having a good understanding of the local community;

h)    they had made a decision to defer the start date allowing them the opportunity to take a stock take in the planning of the service.  It was planned to have a soft launch in September;

i)     the quality of the call handlers had been subject to press coverage.   There would be at least one clinician available for every 6 call handlers.  SWAST staff were the best trained staff in the country and they were sharing good practice with the other areas;  

j)     they would take the implementation slowly to enable them to iron out any issues and would closely review the process during this time.

In response to questions raised, it was reported that -

k)    the service would be based in Exeter which provided a synergy with 999 calls already based in Exeter;

l)     they would be keeping a close eye on Cornwall.  As part of the planning process they had made switches based on neighbouring numbers.  They were also working closely with the Emergency Department in advance of the implementation of the service.

Agreed that -

1.         the Panel receive a progress report on Derriford’s A&E figures in November and an officer to attend if progress has stalled/declined (to include other wider aspects of preventing urgent care).

2.         the Panel accept the open invitation to visit the SWAST Headquarters in Exeter.

3.         the Panel to receive a progress report on the implementation of NHS 111 at its meeting on 13 February 2014.

3.         a colour copy of the Emergency Department Performance Improvement Plan is circulated to Panel members.

(Councillor Mike Fox was present at the meeting from the agenda item onwards).