Agenda item

To update the Health and Wellbeing Board on winter planning.

Steve Vo (Assistant Director of Integration and Delivery, NHS NWL) introduced the report, which detailed the winter planning journey that had started in July 2022. He highlighted the following key points:

·         A total of £3.35m had been secured across the system, which he felt demonstrated good collaborative working across health and social care partners to structurally come together to create schemes and commit to a reporting regime.

·         Positive feedback had been received from service managers across the Council, NHS NWL, CLCH and CNWL.

·         February data showed a rise in A&E and non-elective attendances and so the data was being looked into to understand the spikes in particular months.

·         Service leads and teams were assessing the current schemes, evaluating data to learn lessons from the past few years in order to plan ahead, and the outcome of that assessment would give a steer on which schemes would need to be prioritised locally and identify appropriate funding to continue schemes going forward.

In considering the report, the following points were raised:

·         The Board asked whether there was any data regarding readmittance to hospital and if that was an area of concern. Lisa Knight (Chief Nurse, LNWUHT) advised that readmission data was collated and could be shared with Steve Vo to be used as part of the evaluation process. She believed readmission to be 8% across the entire organisation, and there would be a need to look at that by borough for the Health and Wellbeing Board. LNWUHT had a requirement to audit readmissions, so they could undertake and share the reasons for readmission, as readmission data could include patients who were readmitted for a reason not related to their original diagnosis or health concern.

·         The Board asked if there was any significant system learning that had been taken from the winter planning schemes over the year. Tom Shakespeare (Director, Integrated Care Partnership (ICP)) advised the Board that they were currently going through the process of reporting back to the ICP the impact of specific winter pressure schemes which they could bring back to the Board at a future date. Each of the NWL hospitals were currently undertaking a peer review and Adult Social Care would be looking to be part of that process in terms of learning what the experiences had been.

·         Lisa Knight added that LNWUHT had been thankful for the support, but irrespective of the winter support schemes put in place it had been a very difficult winter. Emergency activity continued to increase at Northwick Park Hospital in particular, and there were significant diverts in place with the London Ambulance Service, with that activity being increased through Ealing as more ambulances were being sent through Ealing due to ambulance queues. She wanted the Board to be aware that some of the experiences in emergency departments continued to be not what they should be, and LNWUHT were in a position where they were ‘plus one-ing’, where patients were moved to wards without a bed on every ward every day. She could see there was a lot of work going on and this was seen on a daily basis, but the issue was that winter pressures did not seem to alleviate during the summer now. She hoped for a commitment to implement year-round planning for the genuine increase being experienced. In response to these pressures, LNWUHT were working with the sector to add 30 additional beds at Northwick Park and were hopefully about that and that it would make a difference on flow.

·         Anecdotally, in terms of supporting the community, there were two key points being identified across NWL. One was the availability and capacity within the system to deal with complex needs within nursing and residential homes, as well as having capacity to support that from a health side and a social care perspective. The second was support around individuals with no recourse to public funds and homeless individuals. Early planning work on those issues was ongoing for the following year.

The Board RESOLVED to note the report.