Health and Wellbeing Board 15 January 2015 Agenda Chairmans - - PowerPoint PPT Presentation

Health and Wellbeing Board

15 January 2015

Agenda

• Chairman’s welcome and introduction
• Apologies for absence
• Minutes
• Declarations of Interest

Chairman’s Announcements

• Better Care Fund letters

Troubled Families Programme and the Early Help Strategy 2014-2017

Carolyn Godfrey (Corporate Director, Wiltshire Council)

Children's Community Health Services Re-commissioning Project

Julia Cramp (Associate Director, Commissioning, Performance and School Effectiveness (joint Wiltshire Council / CCG))

Primary Care Co-Commissioning

Jo Cullen (Group Director, Wiltshire CCG)

Community Services Tender

Debbie Fielding (Chief Officer, Wiltshire CCG)

Learning Disability and Winterbourne View Update

James Cawley (Associate Director, Wiltshire Council) Jacqui Chidgey-Clark (Director of Quality and Patient Safety, Wiltshire Clinical Commissioning Group).

Wiltshire Pharmaceutical Needs Assessment

Kate Blackburn Public Health Specialty Registrar

Responsibilities of the Health and Wellbeing Board for PNAs

• Health and wellbeing boards must publish their first PNA by 1 April

2015, with a requirement to: – Assess needs for pharmaceutical services in its area, and – Publish a statement of its first assessment and of any revised assessment. – This should be followed by a revised assessment within three years

• f publication of the first assessment. There is a legal requirement to

consult for a minimum of 60 days during the production of a PNA.

Development of Wiltshire’s PNA

The Wiltshire PNA was developed by the multi-agency PNA steering group with membership from:

• Wiltshire Council Public Health
• Wiltshire CCG
• NHS England
• Swindon and Wiltshire Local Pharmaceutical Committee
• Healthwatch Wiltshire

Consultation

• The required 60 day period of consultation took place between October

2014 and December 2014 on the Wiltshire Council websites consultation page, as agreed in the PNA project plan.

• Responses to the consultation were received from:

– Swindon HWB – Gloucestershire HWB – Somerset HWB – Hampshire HWB – Swindon and Wiltshire Local Pharmaceutical Committee – Dorset Local Pharmaceutical Committee – Royal United Hospitals, Bath NHS Foundation Trust – Wessex LMC – NHS Contract and Policy Manager, Rowland’s Pharmacy

Recommendations

• PNA steering group continue to meet following publication of the

PNA to review areas of development that were highlighted in the needs assessment.

• Initial key areas for review should include but not be limited to:

– Re-commissioning of a palliative care service on demand. – More integrated working between community pharmacy, community hospitals and acute hospitals. – Mechanism for review relating to the army re-basing and new housing developments within the council’s Core Strategy.

Health and Wellbeing Peer Challenge

Cllr Jane Scott OBE (Chair, Health and Wellbeing Board) Dr Steve Rowlands (Vice Chair, Health and Wellbeing Board)

Police and Crime Commissioner Update

Angus Macpherson (Police and Crime Commissioner)

Visit www.wiltsmessaging.co.uk

Prioritising messages

Use of Community Messaging

• 4,616 members of the public are on the

system

• Community messaging launched in 22

community areas out of 27

• Will be live across whole of Wiltshire and

Swindon by mid-February

• Collaboration opportunities with partners

Wiltshire and Swindon Community Messaging

Thank you Any questions?

Systems Resilience (Winter Planning)

Jo Cullen (Group Director, Wiltshire CCG) Carolyn Hamblett (Associate Director, Wiltshire Council)

‘The right healthcare, for you, with you, near you’

WHOLE SYSTEM ACTIVITY: CHRISTMAS AND NEW YEAR PERIOD 14/15 (1st December to 9th January)

‘The right healthcare, for you, with you, near you’

NHS111:

• Lower A&E referrals on Saturdays despite spikes in calls,

huge spike in calls on the day after Boxing day, recent upward trend in A&E referrals.

• NHS 111 Calls offered over the same 40 day period are

annually up 29% with calls answered up 21%.

• Average Ambulance dispatch rate in the 40 day period in

13/14 = 10.57% and in 14/15 increased to 11.45%.

• Average A&E referral rate in the 40 day period in 13/14 =

6.65% and in 14/15 decreased to 5.11%.

‘The right healthcare, for you, with you, near you’

0% 2% 4% 6% 8% 10% 12% 14% 16% 200 400 600 800 1000 1200 1400 1600 1800 2000

1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri

NHS111 (Wilts & BaNES)

Calls Ambulance Referral % A&E Referral %

‘The right healthcare, for you, with you, near you’

OUT OF HOURS

• OOHs – Saturdays busier than

Sundays, for advice calls and PCC attendances.

• Increased number of GP advice

Saturday 27th Dec

‘The right healthcare, for you, with you, near you’

25 50 75 100 125 150 175 200 225 250 275 300 325 350 375

Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

OOHs Calls

Telephone Advice Calls PCC Attendances Home Visits

‘The right healthcare, for you, with you, near you’

ACCESS TO CARE

steady upward trend in ATC calls and recent rise in ATC referrals.

‘The right healthcare, for you, with you, near you’

50 100 150 200 250 300 350

Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

OOHs - Access to Care

One number ATC calls ATC Referrals

‘The right healthcare, for you, with you, near you’

AMBULANCE

• Upward trend in number of incidents

now looks to be reversing to predicted levels

‘The right healthcare, for you, with you, near you’

50 75 100 125 150 175 200 225 250 275

Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

SWAST Incidents

Red (1&2) Incidents Total Incidents

‘The right healthcare, for you, with you, near you’

AMBULANCE CONVEYANCE

Trust trends do not move in parallel.

‘The right healthcare, for you, with you, near you’

10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85

Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

SWAST (2) - ED Conveyance

GWH RUH SFT

‘The right healthcare, for you, with you, near you’

A&E CONVERSION: ATTENDANCE TO ADMISSION

Increased rate of A&E conversion at all 3 Acutes.

‘The right healthcare, for you, with you, near you’

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

A&E Admission Conversion Rates

GWH RUH SFT

‘The right healthcare, for you, with you, near you’

A&E 4 HOUR TARGET

• GWH and RUH much lower than SFT and all have

taken a hit since Christmas Eve.

• A&E attendances were higher this period 2014/15

compared to 2013/14 at all 3 hospitals but MIU attendance were down.

• The Type 1 A&E attendance growth was +14% at

GWH, +5% at SFT and +1% at GWH but MIU attendances were down 4%.

‘The right healthcare, for you, with you, near you’

45% 50% 55% 60% 65% 70% 75% 80% 85% 90% 95% 100%

Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

A&E <4Hr Rate (95% Target)

GWH RUH SFT

‘The right healthcare, for you, with you, near you’

MEDICAL OUTLIERS

Bed pressures increased from 27th December.

‘The right healthcare, for you, with you, near you’

20 40 60 80 100 120 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

Medical Outliers

GWH RUH SFT

‘The right healthcare, for you, with you, near you’

>14 DAY STAYS

INCREASED SINCE CHRISTMAS

‘The right healthcare, for you, with you, near you’

20 30 40 50 60 70 80 90 100 110 120 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

>14 Day Stays

GWH RUH SFT

‘The right healthcare, for you, with you, near you’

DELAYED TRANSFER OF CARE

• Some discrepancy between 100 day

dashboard and weekly reporting

• More detail in 100 day challenge

update

‘The right healthcare, for you, with you, near you’

5 10 15 20 25 30 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

DToCs

GWH RUH SFT GWH Comm AGW

‘The right healthcare, for you, with you, near you’

SOCIAL CARE PACKAGES

Funded packages of care have reduced since Christmas.

‘The right healthcare, for you, with you, near you’

3250 3260 3270 3280 3290 3300 3310 3320 1800 1810 1820 1830 1840 1850 1860 1870 1880 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

Social Care Packages

Care Home H2LaH

‘The right healthcare, for you, with you, near you’

INTERMEDIATE CARE

The number of intermediate care clients has been steadily increasing.

‘The right healthcare, for you, with you, near you’

20 40 60 80 100 120 140 160 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

Intermediate Care - Number of Clients

Step up Step down D2A War/Sav Step up

‘The right healthcare, for you, with you, near you’

INTERMEDIATE CARE LENGTH OF STAYS

long stays have reduced recently at all sites after increases seen in the week after Christmas

‘The right healthcare, for you, with you, near you’

20% 30% 40% 50% 60% 70% 80% 90% 100% 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

Intermediate Care - % with Excess length of stays

Step up Step down D2A War/Sav Step up

‘The right healthcare, for you, with you, near you’

PATIENT TRANSPORT SERVICES

Reflects less discharges at weekends

‘The right healthcare, for you, with you, near you’

0% 20% 40% 60% 80% 100% 120%

5 10 15 20 25 30 35 40

Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri 1st Dec 2nd Dec 3rd Dec 4th Dec 5th Dec 6th Dec 7th Dec 8th Dec 9th Dec 10th Dec 11th Dec 12th Dec 13th Dec 14th Dec 15th Dec 16th Dec 17th Dec 18th Dec 19th Dec 20th Dec 21st Dec 22nd Dec 23rd Dec 24th Dec 25th Dec 26th Dec 27th Dec 28th Dec 29th Dec 30th Dec 31st Dec 1st Jan 2nd Jan 3rd Jan 4th Jan 5th Jan 6th Jan 7th Jan 8th Jan 9th Jan

Arriva PTS

Discharges % Notifications before 1600hrs

‘The right healthcare, for you, with you, near you’

A&E ANNUAL GROWTH FIGURES

Activity by Trust – not just Wiltshire patients All 3 hospital A&E activity above last years same period

‘The right healthcare, for you, with you, near you’

500 700 900 1,100 1,300 1,500 1,700 13/14 14/15 13/14 14/15 13/14 14/15 13/14 14/15 GWH Acute RUH SFT GWH MIUs Dec Wk1 Dec Wk2 Dec Wk3 Dec Wk4 Jan Wk1

‘The right healthcare, for you, with you, near you’

3,000 4,000 5,000 6,000 7,000 8,000 9,000 13/14 14/15 13/14 14/15 13/14 14/15 13/14 14/15 GWH Acute RUH SFT GWH MIUs

5Wks ED Attendance Volume

Better Care Plan and 100 Day Challenge Update

James Roach Integration Director Wiltshire Council (WC)/Clinical Commissioning Group (CCG)

NHS Five Year Forward View

Geoff Shone (NHS England, Local Area Team)

www.england.nhs.uk

NHS England Organisational Alignment

January 2015

www.england.nhs.uk

Why ?

• In order that NHS England is structured so that it

can focus on core priorities as determined by the Board , the Mandate and Parliament.

• To contribute to the required reduction in running

costs mandated for all parts of the commissioning system

New area teams

www.england.nhs.uk

NHS England

4 Regions;

• North
• Midlands
• South
• London
• 12 sub regions
• A central team based in Leeds and London

www.england.nhs.uk

• South East – covering Surrey , Sussex Kent & Medway.
• Wessex – covering Dorset; Hampshire & Isle of Wight.
• South West – covering Devon , Cornwall Isles of Scilly,

Somerset, Bristol, North Somerset, South Gloucestershire.

• South Central – covering BaNES , Gloucestershire,

Swindon , Wiltshire, Buckinghamshire, Berkshire, Oxfordshire

South of England

www.england.nhs.uk

South Central – Senior Team

Director of Commissioning Operations Rachel Pearce ( Interim) Nursing Director Jan Fowler Medical Director TBC Director of Finance James Drury Director of Commissioning Debra Elliott Director or Operations & Delivery Julia Davison

Agenda

• Date of Next Meeting – 26 March 2015
• Urgent Items