Meeting documents

To receive the performance report.

This paper provided the Committee with an update on the Somerset CCG Integrated Quality, Safety and Performance. The CCG has established performance monitoring meeting with all providers of healthcare services, the Committee considered the summary of the escalation issues for quality, safety and performance against the constitutional and other standards for the period 1 August 2018 to 30 November 2018.

The report provided a summary by exception which generally highlighted areas where the performance is not as good as we would want it to be. The Committee agreed this should not detract from all the excellent work in Somerset by health services which are not mentioned.

In 2018/19 the demand for both elective and emergency services in Somerset continued to increase compared to the previous year. This led to increased waiting times particularly for diagnostics and elective treatment. The CCG and Health providers have identified particular areas of pressure and these are monitored with support from the Somerset Referral Management centre to offer alternative choice to individuals. The increase in people who have long waits continues to be a concern against the national target of zero.

The overall Somerset position with regards to the Care Quality Commission (CQC) ratings in the Safety Domain remains challenged, with all Trusts in Somerset rated as Requires Improvement. The CCG has undertaken an analysis constructed by presenting CQC findings and each individual Trusts’ consequential action plan, using a high-level summarised descriptors of the CQC lines of enquiry under the safe domain and will continue to work closely with all commissioned services to deliver an improved position. The key lines of enquiry include: Safeguarding and protection from abuse, managing risks, Safe care and treatment, Medicines management, security of records, mandatory training, recruitment checks, Track record and Learning when things go wrong.

The Committee noted the report and were keen to celebrate the achievements over the past year. Worth noting is the NHS Staff survey that resulted in Taunton and Somerset NHS Foundation Trust being in the highest 20% nationally for positive staff response, the CCG Safeguarding Children Strategy and Dashboard now complete and Home First quality metrics and contract specification in place with the Trusts.

The Committee suggested that the discharge letters send out after hospital admission should be addressed to the patient and not the GP as this would personalise the service.

 The Committee welcomed the focus on suicide prevention and asked for an explanation of ‘Kooth’. It was explained that this is a confidential and anonymous web-based service for young people with mental health issues. Such is the success that the CCG is looking to commission additional on-line activity to support this group. There was some discussion about Young People and Mental Health and the Committee were informed that this was to be discussed at the Scrutiny for Children and Young People later this month.

The Committee asked if those on the waiting list for treatment or investigation were kept informed of progress. They were informed that regular communication was not routine until they had reached the 38-week point. At this stage the patient is critically reviewed to assess the situation.

In terms of the performance of SWAST the Committee were interested to know how the CCG assess the resource requirement for ambulances. There are daily updates on performance while targets are not being met, ‘comfort calling’ – a call to those waiting for an ambulance to make them aware they have not been forgotten and to make sure the situation has not altered. The CCG has also commissioned some emergency response vehicles based in Somerset to ‘hear and treat’ or ‘see and treat’ to reduce the number of patients who are simply transported to A&E for treatment. The pressure on the service is not lack of vehicles but the challenge of retaining trained and qualified staff.

The Committee were interested to learn of any impact the major incident in Salisbury had on the ambulance service. They were informed there were some, but they had been absorbed.

The Committee asked for a more detailed report on the South West Ambulance Service Trust.

The Committee were informed that demand for cancer treatment was up 18%. This is a result of early diagnosis and detection. There had been a slight increase in waiting times but in this case, patients are managed by clinicians.