Agenda item

To receive the enclosed presentation followed by an opportunity for discussion and member questions.

The Committee received and discussed a presentation setting out details of the local NHS winter resilience framework and 2022/23 winter response.

Summary of main points raised:

1. The presentation had been circulated to committee members in advance of the meeting.  The key areas covered by the presentation were:

a. The national context and background to the ICB’s local winter planning.

b. Overview of the content of the winter plan.

c. Summary of Bristol City Council adult social care mitigations.

d. Forecasts against the 6 key ‘winter metrics’ including 999 total call handling time, category 2 ambulance response times, ambulance handover delays and hospital bed occupancy forecasts.

e. Regional hospital bed modelling and known and further mitigations.

f. Details of the BNSSG winter escalation framework (co-ordination and oversight of delivery).

g. Details of the communications approach (including those related to the Covid seasonal booster update).

2. It was noted that (as highlighted by the Care Quality Commission) there were national issues around long waits for ambulances, including ambulance ‘waiting time’ outside Accident and Emergency (A&E) units.  This was related to the issue of some patients being stuck in hospital beds due to shortages in social care support required to enable them to leave hospital, people also being stuck in emergency departments waiting for a hospital bed to be available to receive treatment, and other individuals stuck waiting for ambulances following emergency calls because the ambulances were stuck outside hospitals waiting to transfer patients. Ambulance ‘clean down’ requirements/time also needed to be taken account of.  These were issues locally as well - in BNSSG, key areas of focus included securing additional capacity in emergency zones where possible but also trying to ensure that patients were able to be transferred to or access the most appropriate clinical setting.

3. It was noted that South Bristol Community Hospital currently closed at 8.00 pm each evening; it was suggested that one option that might be considered was to extend the opening hours at this site to midnight to relieve some of the pressure on A&E units elsewhere during the late evening.   It was noted that funding and staff availability and the overall staff recruitment position would need to be factored into assessing any options to increase capacity. 

4. It was noted that it was also important to encourage use of community pharmacists where this was appropriate.

5. It was noted that important lessons had been learned from the Covid virtual ward experience, especially in terms of assisting patient ‘flow’ and following the principle of ‘right patient, right place, right time.’

6. It was noted that Covid and Norovirus rates would form key elements in monitoring and managing demand through the winter period.  In terms of the ‘6 key metrics’ slide, further detail on the data could be made available to committee members on request.

7. In terms of the operational modelling scenarios, it was noted that these would be kept under ongoing review, noting also that the impact of any staff industrial action would need to be assessed carefully.   It was noted that through ‘Operation Arctic Willow’, each ICS was also stress-testing the health service ahead of the scenario of extreme winter operational pressures and possible industrial action.

The Committee RESOLVED:

- To note the above update and information.