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 overview on the performance of the local NHS based on a range of national priorities and other agreed local standards.
The report included an update on ambulance response times in Gloucestershire by the South West Ambulance Service Foundation Trust (SWAST). Following on from the report to the committee at the October meeting, the committee was informed that the Chair and Vice Chair of HOSC had met with the Chief Executive and County Commander of SWASFT on 15 November 2021 to consider issues impacting on the performance of SWAST and on local hospital admissions.
At the meeting on 15 November, it had been explained that the issues were recognised as a national issue and not specifically affecting the South West or Gloucestershire. Key outcomes from the discussion included acknowledgement that current performance issues constituted a ‘system failure’ rather than a failure in any one part of the system and the need for more direct communications to HOSC in the form of detailed reports, (to form part of the GCCG performance and accountable officer reports to HOSC).
To strengthen communication channels between SWAST and HOSC and to aid members understanding of the criteria relating to ‘system escalation’ levels 1 to 4, SWAST agreed to examine current communication arrangements and consider how best to cascade incident declarations to HOSC. SWAST also agreed to provide details on system levels/organisation levels and escalation criteria.
Key matters included in the performance report included: -
1) Recovery of NHS service activity and performance in response to the effects of the COVID-19 Pandemic was underway, with urgent care services in particular seeing additional demand compared with periods of national lockdown;
2) The performance of cancer related services remained strong and was showing good recovery in comparison with regional peers for elective services, particularly in local imaging diagnostic services and in the reduction of patients waiting over 52 weeks for treatment;
3) Demand for all healthcare services, (in conjunction with possible COVID-19 pressures due to increased transmission of the delta variant), was still likely to impact on performance and the recovery process in the months to follow. Analysis was ongoing on the longer-term impact of COVID-19 on services and patient behaviour (including health inequalities). It was confirmed that Healthcare services were undoubtedly at their most challenged at this current time;
4) Significant issues were evident in terms of system flow, resulting in huge pressures across the whole system;
5) Resources were not a key issue at the present time; the key issue was the pressures impacting on, and sustainability, of the workforce;
6) Processes were in place to invest in future healthcare provision secured via developer contributions/local authority Section 106 planning decisions;
7) A significant amount of work was being invested in achieving the appropriate balance between patients requiring hospital care and receiving care within their local areas/own homes. The Home First Reablement initiative formed part of this investment;
8) Further to planned changes to consultation procedures, no additional pressures were being placed on GP’s in terms of making referrals for treatment; the introduction of a quick referral system removed excessive, often unnecessary, steps in the referral pathway, allowing for a speedier, more streamlined diagnosis;
9) The challenges of the Winter Programme and the potential for new variants of the COVID-19 coronavirus to emerge were under constant review and not to be underestimated.
The report was noted.