Agenda item

A report advising the Committee on local and Greater Manchester-wide elective waiting lists and clinical prioritisation considerations.

The Committee considered an update report from the Strategic Director of Commissioning/Chief Operating Officer outlining the position in relation to recovery of elective activity across GM following Covid which was outlined within the report. 

The Committee was advised that the pandemic had created significant challenges for providers in Greater Manchester in their processing of patients, irrespective of whether they are on admitted or not-admitted pathways and that this difficulty spans all ages and all specialities. 

It was reported that the consequences of this was a substantial increase in waiting times, including a level of patients waiting more than 52 weeks.  The Committee was advised that this scenario had not been seen for many years. 

It was further reported that addressing the challenge would require collaborative working across providers, including the use of the Independent sector and a focus on pathways between primary and secondary care.  This work will provide opportunities for transformation and innovation in many of our specialities including within community and primary care services.

The Committee was advised that collaborative working across hospital and community cells in GM had clearly been delivered successfully during the COVID pandemic and despite all the challenges new pathways, and innovative clinical practice has been delivered to the benefit of the GM population.  The provision of mutual aid for critical care had exemplified this collaborative practice.

The Committee was further advised that GM had been disproportionately affected by the Covid pandemic, experiencing three waves, each having a significant impact on ability to deliver wider elective activity.  The decline following the third was also notably slower in GM than other parts of the North West Region and across England with critical care capacity still 50% Covid in GM compared to c 33% in Lancashire and Cumbria and Cheshire and Mersey.

Highlighted within the report was the GM Elective Recovery position, the GM Trust Recovery position and the overall GM approach to recovery.  Recovery of elective activity was continuing across GM.  There had been an improvement in performance across several points of delivery, including day case and ordinary elective.  There was concern that the ongoing Covid 19 and urgent care pressures would impact this delivery over the coming weeks.

It was reported that the GM elective indicated that the total number of patients waiting was 395,805, with the number of patients waiting over 52 weeks having increased to 33,156 patients (9% of total waiting list).  The three specialities with the biggest number of over 52 weeks continued to be Trauma and Orthopaedics, General Surgery and ENT.  Details of Recovery and Reform within prioritised elective specialities was also outlined within the report.  Details of latest Independent Sector activity was also detailed in the report showing performance against the 2019/20 baseline contracted activity.

Details of Health Inequalities in Elective Recovery were outlined in the report along with actions being considered to address the issue.  It was reported that the GM communications team have developed an updated stakeholder briefing in response to the increase in demand being experienced across the system.  This included key messages regarding elective recovery which were outlined within the report.  A ‘Locality offer’ framework had also been established and the weekly GM waiting list communications group had been established to progress this work at pace, support by additional external communications support, to roll out the framework by the end of August 2021.

It was reported that targeted engagement with the public was on-going through localities.   Stakeholder engagement continued with Primary Care Board and PCN Network scheduled within the next fortnight.

It was recognised by the Committee that NHS employees and gone well beyond the call of duty.  Thanks, and congratulations were expressed from the Committee to all employees of the NHS.

Members requested and received clarification on the following:

·         How long can NHS maintain the service?  The Committee was advised that Northern Care Alliance (NCA) would be delivering several programmes to staff following transition from Pennine.

·         Disjointed IT systems preventing communication and updated records.  It was suggested that that IT team attend a future meeting of the Committee to present a road map.

RESOLVED –

1.    That the Health Scrutiny Committee noted the update

2.    That a Commissioner chaired informal workshop be arranged for the Health Scrutiny Committee.