Agenda item

Gloucestershire Integrated Care System (GICS) Performance Report

To receive an update on the performance of the Gloucestershire Integrated Care System (GICS) against NHS constitutional and other agreed standards.


The committee noted the Gloucestershire Integrated Care System, (ICS), Performance Report relating to the performance of the NHS Gloucestershire Integrated Care Board. The report included information on performance, quality and workforce. The report was taken as read at the meeting.


To view the contents of the report please refer to the link on the Gloucestershire County Council website at the link here.


Key achievements reported at the meeting included: -


      i.        The urgent and emergency care programme had achieved the majority of planned commitments with reductions in the numbers of long stay patients in acute hospitals and good performance against the 2 hour urgent care community response target.


    ii.        Diagnostic performance for the NHS Gloucestershire ICB was ranked first nationally.


   iii.        Despite the challenges of industrial action, the elective recovery fund (ERF) position for Quarter 1 2023/24 was on plan.


   iv.        Total primary care activity remained above plan, and urgent provision continued to benchmark well nationally.


    v.        Primary Care services had undergone necessary changes in order to meet demand. Emphasis was placed on the need to reduce pressures in Primary Care.


   vi.        Cancer performance targets were good, with 96.8% of patients seen within 2 weeks of referral on a cancer pathway.


Key information noted at the meeting included: -


      i.        Ongoing industrial action continued to impact on the system, with mitigation work taking some of the focus away from other areas of work, including urgent and emergency care transformation work.


    ii.        A consequence of the industrial action had resulted in a significant number of cancellations of elective procedures and appointments. Although this had not caused the elective recovery fund position to fall, it was, nevertheless, impacting on the system’s ability to attract additional funding.


   iii.        Industrial action was also constraining options for patients likely to breach the 78 week wait for elective treatment.


   iv.        Hot weather in early September had impacted on performance, particularly in relation to the performance of the South West Ambulance Service NHS Foundation Trust. Increased demand had been reported across all systems within the South West, impacting on Category 2 response times and handover delay performance.


Member Questions


Responding to concerns about Children’s and Adolescent Mental Health Services (CAMHS), the Chair suggested that a scrutiny task and finish working group be established to consider issues relating to Children’s Mental Health. Noting current waiting times for hospital appointments, specific focus to be made on waiting times for children obtaining hospital appointments.


Representatives from the Gloucestershire Health and Care NHS Foundation Trust confirmed that progress was being made to reduce waiting times for CAMHS appointments, but that these remained high due to workforce challenges and recruitment issues. It was noted that significant work to support children’s mental health services was being undertaken in local schools and in partnership with other service partners.


Speaking in support of the proposal to establish a scrutiny task and finish group, one member raised concerns about the provision of services available to children and families outside of term time and where children were unable to attend school. The Director of Public Health informed members that further services were being developed, and that a half day information session for schools was planned to promote and inform what offers were available to children and families. It was agreed that updates on support services available to children, (during term and out of term time), would be included in the next update report to the committee. Action: Chief Executive of Gloucestershire Health and Care FT and Director of Public Health


The committee supported the proposal for a joint scrutiny review of issues relating to children’s mental health, pending a suggestion from the Executive Director of Adult Social Care, Wellbeing and Communities that contact be made with the Chair of the Children’s and Families Scrutiny Committee to enquire whether this was an area of work that had already been explored by the committee or if an item was planned in the future.


Members were advised that, if a scrutiny task group was thought to add value to the work of the committee, (in relation to gaps in children’s mental health services), a scrutiny scoping document outlining the purpose and anticipated outcomes from the review would be required. The scoping document to be submitted to the Corporate Overview and Scrutiny Committee for consideration/approval. Action: Democratic Services


Questioning the impact of industrial action on the delivery of services over the summer months, other areas for concern raised at the meeting included; performance issues in urgent and emergency care impacting on patient hospital discharge, performance issues in primary care, weekend mortality rates and pharmaceutical dispensary and recruitment issues. Members were reminded that the committee would be considering a report on Pharmacy/Optometry/Dentistry (POD) Services at the November meeting.


Referencing concerns about communication issues in relation to Covid-19 and the NHS Gloucestershire winter vaccination programme, Deborah Lee, Chief Executive of the Gloucestershire Hospitals Foundation Trust, informed members that Gloucestershire had been accepted to participate in a national ‘patient portal’ pilot scheme, which would be a huge benefit to improving communications.


Responding to requests for guidance to enable better informed decisions on when it is appropriate to visit local GP’s and Urgent and Emergency Care Units, it was suggested that information on the patient portal pilot scheme and other forms of public communications be included in an update to the committee at a later meeting. Data on variations in GP appointment waiting times for the county was also requested. Actions: NHS Gloucestershire


The report was noted.

Supporting documents: