Agenda item

Report and presentation received which provided the Commissioning Partnership Board with an overview of the winter planning process for urgent care services underway in Oldham.

Members were advised that the Oldham urgent care system winter plan was built upon the plans of previous years and the interventions that had been put in place to manage peaks in demand over the winter period and over the statutory holiday periods. In aiming to achieve continuity of services, the co-operation of all partner agencies was essential and stakeholders had contributed to the development of the Oldham plan.

The aim of the winter plan was to set out the arrangements for the delivery of primary and community care, out-of-hours and hospital services over the winter period to ensure that the provider partners in Oldham responded effectively to periods of high predicted or unpredicted activity, the extended public holiday periods and the possibility of high demand as a result of wide spread illness.

The plans for 2018/19 focused on the following areas:

·         Supply, focus on supply side pressures as those will be longer lasting than demand pressures

• Capacity, Maintain assessment capacity and bed availability to keep pace with emergency admissions
• Seasonal pressures, make plans for increased pressures on Mondays, Christmas and early January

In terms of supply actions included:

• System resilience funding was being used to support urgent care services through the provision of additional beds for acute medicine and paediatrics.
• Robust reviews of length of stay and a focus on care planning for long stay patients
• A series of Multi Agency Discharge Events to support system flow.
• A re-launch of the patient choice policy across the hospital, intermediate care and reablement.
• Flu vaccinations –all organisations are encouraging staff to take up the offer of a flu vaccination.
• A strengthening of the Discharge to Assess approach.

In terms of Capacity actions included:

·         Block purchasing of care home capacity

·         Additional Intravenous therapy service capacity

·         Rapid access step up and step down short term nursing and therapy support

·         Additional primary care streaming capacity at the front end of the hospital

·         Ambulance liaison role in place.

In terms of seasonal pressures, actions  to support system resilience over the peak festive season included:

·           Communications to inform residents about service availability over the festive period.

·           All providers to ensure robust plans were in place for the bank holidays, extreme weather and flu.

·         Escalation processes and procedures reviewed.

·         Work to support provision in areas of greatest needs including EMI beds

Primary care partners had  been asked to look at their capacity over the peak festive season and to convert capacity to ‘on the day’ appointment availability.

The winter resilience grant had been used to compliment the above arrangements and included;

·      Access to Extra care Housing.

·      Enhanced payment to home care providers over the festive period to incentivise capacity.

·      Seven day Social Work cover at the hospital

·      A strengthening of the Discharge to Assess model with the recruitment of two temporary nurses to support discharges to care homes with nursing.

The Board discussed elements of the presentation and report and raised the following matters:

·         Risk assessment /approach

·         Senior decision making within the plans

·         New ways of working

·         Joined up approach with providers

·         Communication plans/platforms with key messaging

·         EMI nursing beds

·         Systemic issues in Urgent Care and addressing those issues

·         Creating capacity wherever possible

RESOLVED – That the Winter Planning for Oldham 2018/19 be noted.