Agenda item

To provide the Health and Wellbeing Board with an update on winter planning.

Claudia Brown (Director Adult Social Care, Brent Council) opened the report, explaining that this was an integrated plan for winter which had been worked on with all partners. Steve Vo (NWL NHS) advised the Board that the focus of the plan was to ensure sufficient levels of beds in both hospitals and the community, enable the best usage of current capacity, and reduce A&E and urgent care demand. A number of schemes had been put in place to mitigate the discontinuation of discharge to assess and support hospital discharge flow, as detailed in the paper.

The Chair invited comments and questions from those present, with the following issues raised:

·         Carolyn Downs (Chief Executive, Brent Council) confirmed that NWL ICS had now received £9m from the government and added £5m themselves for winter planning, who were the only ICS who had contributed their own funding. Social care was no longer excluded from receiving that funding. She had sent a letter from herself and Tom Shakespeare to the ICS Chief Executive to explain that the only way to help flow from hospital was for more step-down and step-up beds, which needed to be NWL wide. Those conversations were ongoing, but she felt it was important there were colleagues based locally who could do brokerage between continuing healthcare and the Council in order to speed up the process. She felt that the position was in better shape now and that the ICS were trying to get this to a better place.

·         Simon Crawford (Deputy Chief Executive, Brent Council) echoed Carolyn Down’s points and highlighted that, from an acute trust perspective, he was very grateful for the support that had been given to prevent unnecessary hospital admissions and support ongoing discharges. By way of an update, he explained that Northwick Park Hospital had been under sustained pressure and the last 8 weeks had seen highly pressurised day-in-day-out demand on hospital beds and acute pathways. He felt that all of the schemes detailed in the report were vitally important to support the Trust in providing safe care to patients and effective discharge. In addition, he had joined some of the discharge calls which were ran well in terms of staff knowing the patient, knowing the case and supporting the discharge. This week, the Trust had given confirmation of funding for beds, which was for additional capacity of 68 beds, with 40 open as of the week of the meeting.

·         The Board asked whether officers were confident staff could be recruited to implement the schemes detailed in the report. Claudia Brown highlighted that staffing was one of the biggest challenges going forward, particularly as ADAS had ceilings for how much agency staff could be paid. There may be a need to go above those levels to encourage staff in. Having said that, not all of the schemes required additional staff, particularly in the region of primary care where beds were being put in through the independent sector. Some of the schemes which had proven successful last year had already began mobilisation with staff as part of that mobilisation. Antoinette Jones (NWL NHS) added that CNWL had assured her that agency staff and existing staff could be used to implement schemes, and 2 voluntary sector providers had confirmed they were ready to mobilise their schemes based on their existing staff.

RESOLVED:

i)              To note the local Winter Planning initiatives.