Agenda item

The Committee considered a report of NHS North East Commissioning Support that gave an update on the transformation of System Resilience Groups (SRGs) to Local A&E Delivery Boards (for copy see file of Minutes).

The Chief Executive of County Durham and Darlington NHS Foundation Trust informed the Committee that performance across the NHS had not been great last year with the 95% performance target dropping to 85%.  It had therefore been decided that the Systems Resilience Group (SRG) was to be replaced with a Local A&E Delivery Board (LADB) from the 1st September 2016.   This requirement was nationally mandated and had a focus purely on Accident and Emergency and the four hour target.  The Board would be chaired by Stewart Findlay, Chief Clinical Officer from DDES CCG and the Chief Executive was herself the vice chair.  The board would be attended at an executive level.  A geographical change had taken place with the membership and the smaller board would no longer have representatives from Sunderland or Tees and would be supported by National Reference Groups.

There were five mandated improvement initiatives of the A&E Plan that the LADB would coordinate and oversee:

•           Streaming at the front door – to ambulatory and primary care

•           NHS 111 – Increasing the number of calls transferred for clinical                 advice

•           Ambulances – DoD and code review pilots; HEE increasing                                     workforce

•           Improved flow – ‘must do’s’ that each Trust should implement to                  enhance patient flow

•           Discharge – mandating ‘Discharge to Assess’ and ‘trusted                            assessor’ type models

The Committee were advised that the winter plans would be brought forward and any lessons learnt from previous years would be drawn upon.

The Chief Executive advised that performance had improved and had been above the 95% target from June to September.  There was a lot of pressure being felt nationally and the Trust were currently sitting 10^th out of 148 trusts in the country.

The Interim Corporate Director of Adult and Health Services said that there was a local authority seat on the board and she advised that the issue of the Winter Plan Submission did cover cross-cutting areas.

The Chairman referred to information received from NEAS stating that the delays to ambulance turnaround was due to 3 hospitals delaying the transfer of care.  The Chief Executive of CDDFT advised that the Ambulance Services were given money to deploy in a way they see fit.  There was an agreement across the North East that amongst the urgent and emergency care network there would not be diversions between hospitals and therefore this would eliminate the transfer of care.  Recent data shared at the LADB had shown a significant reduction however due to delays in Sunderland overall performance for NEAS had not changed.  Members were advised that a lot of work was being carried out to focus on the whole of the North East with partners to minimise the risk.  She said that figures would be sent to Committee members.

The Assistant Director of Communications & Engagement, NEAS advised that there had been increased pressure in handover delays in Sunderland and Cramlington that had a ripple effect for the whole service.

Referring to paragraph 4.5 of the report, Councillor Temple was advised that funding was on the LADB agenda and a small pot of money had been reserved.  The Director of Primary Care, Partnerships and Engagement, North Durham and DDES CCGs advised that this was due to an inadequate evaluation report being produced in respect of an element of the previous System resilience arrangements and this would be recalibrated into the new arrangements.   Councillor Temple was re-assured that friction was not built into the new arrangements.

Resolved:

(i)            That the report be accepted.

(ii)          That the developments, achievements and targets set for new schemes be noted.