Agenda item

To receive an update on the performance of the Gloucestershire Clinical Commissioning Group (GCCG) against NHS constitutional and other agreed standards.

The committee received an update on the performance of the NHS Gloucestershire Clinical Commissioning Group, (GCCG), including notification that NHS CCG oversight assessments published in November 2020 had rated Gloucestershire CCG as ‘Good’ against NHS Constitutional and other agreed standards.

With the exception of A&E and Ambulance Category 1 response times, performance against key standards continued to follow national trends. It was confirmed that there had been a significant decline in overall A&E performance nationally during the 12 month period to November 2020, (attributed to the recent surge in Covid-19 cases and in response to national lockdown measures).  Locally, 4 hour performance targets remained a concern. Ongoing pressures in the availability of acute hospital bed spaces was making it increasingly challenging to meet the required standards.

Across all other standards, both the national and GCCG position showed general improvement. Members noted, however, that the impact of the second wave of COVID-19 was likely to have a negative impact on performance during December 2020 and January 2021.

With no significantly large increase in COVID-19 admissions evident during the initial months of the pandemic, this position had changed in recent months, with admissions rising steeply at the end of October 2020. Workload pressures continued throughout November and December, with notable repercussions from the impact of increased COVID-19 admissions and occupancy at Gloucestershire Royal Hospital. Current reports indicated continuation of this challenging situation, particularly in terms of bed occupancy and hospital flow.

To relieve some of the pressures on hospital admissions, efforts had been made to treat some patients experiencing COVID-19 symptoms at home as part of the Home First programme and from the Virtual COVID-19 Ward. Both provisions took into account the risks to staff when looking after COVID-19 patients in non-hospital environments. COVID secure arrangements and regular monitoring to detect early signs of deterioration in patients receiving treatment at home were important considerations. The roll out of the COVID-19 vaccination to NHS staff, (reported in an update to the committee under item 10 of the agenda), was proving very successful.

Earlier in the meeting, it had been reported that ambulance service activity in the Gloucestershire area had increased in the 12 month period between January and December 2020, (during the pandemic). Although activity had decreased slightly during the initial lockdown, there had been a significant increase in activity since December 2020, with notable increased pressure on ambulance service crews and in the frequency of handover delays. An update on SWAST service performance activity to be presented at the 13 July 2021 meeting.

Expanding on the extraordinary response by Gloucestershire ICS during the pandemic, NHS professionals commended the work and commitment of NHS staff. Dr Andy Seymour said it was a privilege to work with staff and colleagues in the fight against the virus. Supported by new and innovative pathways, it was hoped the performance of the Gloucestershire ICS would continue to hold strong during this challenging time.

The committee commended the work of NHS staff and the support of care workers and volunteers in the local communities for the extraordinary being taken to protect the residents of Gloucestershire.

Highlighting one of the more successful outcomes for Gloucestershire, it was reported that, whilst delivery of some cancer services had struggled nationally, Gloucestershire had continued to provide a good level of cancer care throughout the pandemic. Conducting remote consultations had been an important shift in maintaining cancer services. Another factor was to offer supported self-management recovery programmes for those completing treatment. Acknowledging the impact of the pandemic on patients’ emotional wellbeing and mental health, it had been proposed that a new working group be established to consider ways of providing psychological care for cancer patients.

The performance report was noted.