Decision details

Integrated Care Board (ICB) Performance Report

Decision Maker: Scrutiny Committee - Adults and Health

Decision status: Recommendations Approved

Is Key decision?: No

Is subject to call in?: No

Decisions:

The Committee had a presentation and report to update them on the Quality, Safety and Performance  of the Integrated Care Board (ICB).

Primary Care Access

The Committee was informed that Primary Care services have continued to experience considerable operational challenges in July 2023 with approximately half of the GP practices in Somerset reporting their OPEL status as OPEL 3 or above (Operational Pressures Escalation Levels). The practices reported pressure still showing in General practice due to staff shortages, sickness and patient demand and annual leave. In July 2023 there were approximately 286,000 primary care consultations with either a GP or other healthcare professional, which is an increase of 4.8% when compared to July 2022. Of these consultations 59.3% were delivered face to face (compared to the South-West Regional average of 66.9% and 6 68.3% in England) and 80.9% were made within 14 days and 43.9% made on the same day.

NHS 111 Service

There are ongoing pressures across the wider UEC (Urgent and Emergency Care) system both in Somerset and nationally. During the cumulative period April and July 2023 there were 62,000 people across Somerset who contacted (and had their call answered) by the NHS111 Service and this represents a 20.1% cumulative increase in demand over this period and comparable increase of 19.9% was also seen in the latest reported month (July 2023). The average speed to answer calls in Somerset improved by 20 seconds in July 2023 to 213 seconds compared to the England average of 159 seconds. There has been a significant reduction in the number of abandoned calls since HUC took over the running of the NHS 111 Service in Somerset from April 2023. Of the total calls received in July 2023 12.4% were abandoned compared to the previous England average of 9.1% and is an improvement upon the previous month. 63.5% of calls were assessed by a clinician or clinical advisor compared to the England average of 43.8%.

Ambulance Performance

The number of people calling the ambulance service in July 2023 was 2.5% lower than the same month in 2022, but on a cumulative basis during the period April to July 2023 there was an overall 0.6% increase in demand.

 

A&E Performance

Demand for A&E services has increased in 2023 and during the cumulative period April to July 2023 attendances to A&E has increased by 2.3% across Musgrove Park Hospital (MPH )and Yeovil District Hospital (YDH) sites, and in July 2023 reduced by 1.9%. In July 2023, A&E 4-hour performance at MPH was at 65.1% and at YDH 67.2%, which is an improvement upon the previous month at both sites. Both MPH and YDH 4-hour performance is above (better) than the National and South-West average and MIU performance of 96.9% is comparable to the previous month.

 

Elective Recovery and Waiting Times

The waiting times expectation in 2023/24 is that there will be no patients waiting in excess of 104 and 78 weeks throughout the year, and the new ambition is for there to be no patients breaching 65 weeks by March 2023. In July there were no patients waiting over 104 weeks and continue to be no patients who are forecasted to breach this waiting times standard as of the end of September.

Diagnostic Waiting Times

The number of patients waiting more than 6 weeks for a diagnostic test or procedure in July 2023 has increased by 501 patients to 3,650, but those waiting in excess of 13 weeks has slightly reduced. The proportion of patients waiting less than 6-weeks in July was 75.5% and achieving the 75% Regional improvement standard.

Cancer Waiting Times

The 28 Day Faster Diagnosis Standard (FDS) performance has improved this month to 73.3% (+4.2% to previous month) and is 9.2% higher (better) than our operational plan of 64.5% for June. The most impacted tumour sites are lower gastrointestinal, gynaecological, Skin and Urological. Key drivers are the shortfall in colonoscopy capacity to meet the significant increase in demand and capacity and challenges within the skin cancer service at University Hospital Bristol and Weston FT and an increase in gynaecological and urological demand YDH and MPH.

Mental Health – Improved Access to Psychological Therapies (IAPT)

The number of people accessing treatment for the year to date in July 2023 using local unvalidated data is 3,719 against the 2023/24 annual target of 13,896 (26.8% of the annual target) and whilst it is recognised that the service remains behind target, we are the only system in the South-West showing a long term sustained upward trajectory.

 

The Committee discussed the report and the following points were raised:-

·         Why the increase in 111 demand? This was in part due to recent national advertising campaign.

·         Is the discharge service a 7 day a week service? Yes

·         Anecdotal reports of 9 month wait for eye treatment. The  Councillor was invited to share the concern in private.

·         Ongoing concerns about Ambulance response times  38 minutes against a target of 18 minutes is of great concern. As it people self-referring to A&E when an Ambulance is not available.

 

The Somerset Scrutiny for Policies Adults and Health Committee welcomed the detailed report and asked to kept up to date with the ICB Quality Performance.

Publication date: 06/10/2023

Date of decision: 05/10/2023

Decided at meeting: 05/10/2023 - Scrutiny Committee - Adults and Health

Accompanying Documents: