Agenda item

This report highlights the key components of the NHS restart and recovery programme.

Discussion:

Members considered reports from the Medway and Swale Integrated Care Partnership and the Kent and Medway Clinical Commissioning Group (CCG) which highlighted the key components of the NHS restart and recovery programme.

The Kent and Medway NHS Restart Programme Director and the Chief Operating Officer for the Medway NHS Foundation Trust introduced the report and also updated Members on the winter plan. With regard to independent sector utilisation, Members were advised that, since the report had been written, two Independent Sector Providers had been removed from the West  Kent element of the national contract.

The Trust had re-commenced 100% of diagnostic cancer and elective services across the Medway and Swale Integrated Care Partnership and the Trust and was on target to meet its October targets.

In terms of winter preparedness, the Trust had submitted its Winter Resilience Plan and initial feedback was that the Medway and Swale element of the plan was seen as an exemplar. Planning for winter was more complicated this year due to EU exit, flu and winter related illnesses and also the second wave of the pandemic. The Winter Plan had been stress tested twice and needed further work but was more developed than ever before.

The following issues were discussed:

• Reporting symptoms - how to encourage people not currently being treated, but who had developed symptoms, to seek advice was queried. Members were advised that a key risk was restoring public confidence to use NHS and primary care services and for people to come forward if they developed symptoms. GP referrals for cancer were down 25% compared to the pre-Covid period. An engagement plan to restore confidence had been drawn up. In response to a query about how the Trust would deal with an increase in referrals, Members were advised that extra capacity and more use of virtual appointments would help reduce waiting lists.

• Cancer referrals – concern was expressed at the reduction in cancer referrals for the last week in the period that the report showed data for. The Committee was advised that the number of referrals had since increased and the figure in the report may increase when the data was re-validated.

• Waiting list targets – the point was made that the continuing to penalise Trusts for not meeting targets was unfair in the current circumstances and whether this was being resisted in Medway was asked. Members were advised that the regional team was encouraging the Trust to address waiting lists on a risk basis and for hospitals to help each other where they had spare capacity. No pressure was being placed on the Trust regarding access targets.

• Staff flu vaccinations – Members were assured this was a top priority and, while not mandatory, staff were strongly encouraged to receive a vaccination. 48% of staff had been vaccinated and the Trust hoped to achieve close to 100% in the coming months. In response to a concern that there may not be enough supplies, Members were assured that there was enough supply for everyone who needed to be vaccinated.

• 111 first deployment – reference was made to media reports that staff had been quickly recruited at the start of the pandemic in the 111 service and some had been required to work in non-Covid secure circumstances leading to illness. This inevitably impacted on the Trust. Members were advised that the Trust had been an early adopter of this system and it had already led to a 6% reduction in visits to accident and emergency. The Trust worked closely with SECAmb and had not needed to raise any concerns.

• Staff welfare – Members expressed their appreciation of the work done by staff over the last few months and queried what was being done to support their welfare and those suffering from fatigue. The Chief Operating Officer assured Members that staff welfare was paramount and any staff experiencing stress or fatigue received support.  The Trust was listening to employees’ experience of the first few months of the pandemic. Well-being hubs for staff had been set up and staff were encouraged to speak to colleagues in other organisations with similar experiences and to also take two weeks leave over the summer. Processes were in place that allowed staff to raise any concerns.

• New tiered lockdown system – whether the Trust’s plans accorded with the demands of the new tiering system across England was queried. The Chief Operating Officer believed that the winter plans were robust enough to meet the demands of the new lockdown system but there was a need to review how the Trust would respond to the requirements of each tier. Services would not be closed down unless there was no other choice. The Director of Public Health added that lessons had been learned from the first lockdown in terms of the impact on other hospital services and there was now a clear focus on people being able to access NHS care in a safe way.

• Elective surgery – it was clarified that the Trust were now moving towards 100% of last year’s planned activity.

Decision:

The Committee agreed to note the update on the NHS restart and recovery programme, as set out in Appendices 1 and 2, of the report.