To receive an update from NHS Representatives. The latest data pack is attached and an update will be presented at the meeting.

The Committee welcomed Dr Mike Burrows, Director (North West) NHS England, Dr Nigel Guest, Chief Clinical Officer of Trafford Clinical Commissioning Group (CCG), Gina Lawrence, Director of Commissioning and Operations of Trafford CCG, Jim O’Connell, Interim Chief Operating Officer of University Hospital South Manchester (UHSM) and Dr Bob Pearson, Clinical Director of Central Manchester Foundation Trust (CMFT) to the meeting. Dr Burrows, Mr O’Connell and Dr Pearson gave a presentation to the Committee which provided an update on the new health deal for Trafford. The key points were:

·         Combined Accident and emergency (A&E) attendances at the three neighbouring hospitals for Trafford residents were 6% less than expected and admissions were 2% less than expected in the period since Trafford A&E department had been downgraded;

·         However, in the case of Wythenshawe Hospital there had been 215 more A&E admissions than expected during this period;

·         Wythenshawe Hospital A&E did not meet its 4 hour performance target in 2013/14 (ie. 95% of patients to be seen, treated, admitted or discharged within 4 hours of arrival);

·         In the first three months of 2014, its 4 hour performance had fallen to below 91%;

·         On Monday, 31 March 2014 there had been 335 attendances at Wythenshawe Hospital’s A&E, and UHSM recognised that a daily attendance greater than 300 was difficult to deal with;

·         In response to their failure to build resilience for A&E winter pressures, which were exacerbated by the downgrading of Trafford A&E to an urgent care centre, UHSM introduced a number of changes that had led to improvements, though some concerns still remained;

·         A key improvement at UHSM A&E was the introduction of a new performance management and monitoring system, which clarified demand and capacity;

·         At CMFT, which took over the running of Trafford Healthcare Trust in March 2012, the rolling HSMR (hospital standardised mortality ratio) at both CMFT and Trafford had fallen since the acquisition, while Trafford’s rolling crude mortality rates for non-elective admissions had fallen by 1%.

A member asked whether the lower than predicted A&E attendance and admissions had led to additional pressure on GPs. Ms Lawrence said there had been no significant increases in GP attendance, but there had been an increase of 10-15% in attendances at walk in centres, but they were able to accommodate this.

The Committee discussed long stay patients. Ms Lawrence clarified that there were two trigger points at which long stay patients were monitored: when they had been admitted for 14 days and at 28 days. She said not all patients in hospitals for these lengths of time were delayed in leaving and many still needed to be in hospital. Currently, UHSM had two long stay patients who were waiting for social services to find them an appropriate place to be discharged to. UHSM currently had 126 people who had been admitted for 28 days or more, 38 of whom were Trafford residents.

A member asked for more details on Alamac and what  ...  view the full minutes text for item 3

A report to the Trafford Strategic Programme Board on the 16^th October 2013 and the Minutes of the meeting are attached.

The Joint Health Scrutiny Committee will be briefed on the following issues.

The Chair explained that the purpose of the meeting was to assess whether the concerns raised by the JHOSC about the New Health Deal for Trafford had been addressed, and to what extent.  It was noted that 23 professionals were in attendance from the NHS to deliver presentations and respond to queries and concerns.  Members were issued with supplementary information provided by the NHS which included print-outs of the presentations which would be delivered and letters of support and assurance from the local NHS Trusts.  Members were issued with supplementary information from the Committee Support Officers’ including  letters from Kate Green MP and Mike Deegan, Chief Executive, CMFT, the Secretary of State’s decision letter of the 11 July 2013, Cllr Newman’s notes of points to be raised at the 3 July 2013 meeting with Mike Burrows, and a note of that meeting.  

Mike Burrows, Director (Greater Manchester) of NHS England delivered the first presentation entitled ‘Greater Manchester Area Team Joint Health Overview & Scrutiny Committee’.  He drew members’ attention to the letters of support and assurance from the local NHS Trusts that were included within their packs.  He explained that the letters met four key assurances as outlined in the presentation.  Dr Nigel Guest, Chief Clinical Officer, Trafford CCG delivered the presentation entitled ‘Developing Integrated Services in Trafford’.  Dr Scott Pearson, GP with interest in Older People, Pennine Care and Gill Eccles, Pennine Care delivered presentations entitled ‘Integrated care in Trafford’.  Dr J Simpson, CMFT delivered a presentation entitled ‘Changing hospital services in Trafford’.

Mr Burrows talked members through the minutes of the Strategic Programme Board (SPB) held on the 16^th October that were contained within the supplementary agenda.  NHS Greater Manchester had agreed to the New Health Deal for Trafford proposals subject to 6 conditions and he advised that conditions 1, 2, 3a and 3b had now been met.  Condition 4 had been noted at the meeting but was not relevant for discussion this evening as it was not applicable at this time.  Conditions 5 and 6 had been met and best practice would be shared throughout the NHS in respect of the latter.  He explained that a significant piece of assurance work had taken place in order to achieve the conditions and noted the letters from the 3 acute hospital trusts, Greater Manchester West Pennine Care and the North-West Ambulance Service that detailed this.   

In respect of Accident and Emergency Department (A&E) performance Mr Burrows explained that the target required 95% of patients to be seen within 4 hours but that it was not further defined to be yearly, monthly or weekly.  Admissions fluctuated within the NHS by season and through the week and the regulator ‘Monitor’ considered a failure to occur where the target was not achieved across 3 consecutive quarters.  The Secretary of State had not provided any further definition than this in his response to the JHOSC referral in his wording “consistently meeting their waiting time standards”.  Mr Burrows explained that A  ...  view the full minutes text for item 5