Agenda item

6.1   The Chair explained that this item allowed us to hear updates from the key local trusts.  He welcomed for the item

  Shane DeGaris (SD), Group Chief Executive Barts Health/BHRUT

  Breeda McManuse (BM), Chief Nurse and Director of Governance for the CE of Homerton Healthcare

  Paul Calaminus (PC), Chief Executive, ELFT

  Jacqui van Rossom (JV), Chief Executive, NELFT

6.2  Members gave consideration to the report North East London Health update  and the Homerton’s additional slide which was tabled.

6.3  SD gave Barts Health’s update focusing on: planning for winter; elective patient recovery, and on staffing and workforce.  There were still great pressures on A&E departments and a lot of work was going on with the Place Based Partnerships to speed up discharges of care, this being compounded by the cold weather and various strike actions. The latter weren’t having a direct impact in east London but there would be indirect impacts from the London Ambulance Service’s forthcoming strike. On Elective care, most of the 2 yr plus long waits had now been cleared and they were moving on to clear 78 and 52 wk waits.  On staffing they had now insourced their Soft Facility Services. Barts had also won a discharge award for work with heart patients.  Good work was also taking place at the new hub at King George’s.  The CQC had visited A&E at Barts and performance was variable but they were looking at each stage of the flow.  On the staffing front they had welcomed a new senior officer focused on Equality and Inclusion.

6.4  BM gave the Homerton Healthcare update. They’d seen a rise in ED attendance combined with wider pressures in the system and they also saw a lot of patient walk-ins.  They do have ongoing staffing challenges and they have experienced a dip in performance on the 4hr waits at A&E and so are looking at flow and pathways.  They’re also focused on discharge so they can improve flow through the hospital.  One of the challenges is admitting out of area patients which makes it more challenging to discharge them and this impacts on flow.  Lousie Ashley had now completed her second month as the new Chief Executive.  On staffing they’re trying to reduce the vacancy rates and have introduced some new financial wellbeing support for the staff and she added that 70 overseas nurses had joined since June.

6.5   The Chair asked about the financial impact of insourcing Soft Facilities Management. SD  replied it would cost more money because they would be paying comparable Agenda for Change rates as with other staff but it was the right thing to do and would generate efficiencies over time.

6.6  Cllr Brewer asked about poor A&E 4hr waits at BHRUT vs Homerton and what role ICS might have here. SD replied that they do share best practice and across NE acute trusts but the trusts vary considerably. The Homerton has fewer ambulances attendances than Queens and the nature of the care in the community across the various boroughs varies significantly.  He added that hospitals that occupy the outer ring of London struggle more with A&E.  They do share best practice and implement the learning and hospitals that don’t have discharge problems will do better on A&E performance. ZE added that the Acute Provider Collaborative is there to take action to tackle these variations but the sites are very different.  Queens is the 4th busiest in London and 12th in the country.  The work that was done in City and Hackney over many years in primary care and community care  and in Neighbourhoods development was vital in reducing attendances in A&E and why the Homerton has done better here.  It is a whole system issue.

6.7  The Chair asked what the CQC had recently concluded about Queens’ A&E.  SD replied that the departments were just too congested. He had asked the system leadership to a Quality Summit on this the following week and he hoped that this collaborative approach would bear fruit.

6.8  The Chair thanked the Chief Executives for their updates and their attendance.

RESOLVED:

That the reports be noted.