Agenda and minutes

The Panel is asked to confirm as a true record the Minutes of the meeting of the Health Liaison Panel held on 1 July 2021 and to authorise the Chairman to sign them.

The Minutes of the previous meeting of the Health Liaison Panel held on 01 July 2021 were agreed as a true record and signed by the Chairman.

Members are asked to declare the existence and nature of any Disclosable Pecuniary Interests in respect of any item of business to be considered at the meeting.

No declarations of interest were made in relation to items on the agenda.

Dr Ruth Charlton (Joint Medical Director) presenting on the following:

•           The future of Epsom and St Helier University Hospitals NHS Foundation Trust in respect of new leadership, a brief overview of on-going developments, and any new initiatives or services for future consideration

•           Winter pressures: The current picture and plans in responding to Covid-19, and the anticipated rise in influenza and other winter-borne illness

The Panel received presentations on the following matters:

a)            The future of Epsom and St Helier University Hospitals NHS Foundation Trust in respect of new leadership, a brief overview of ongoing developments, and any new initiatives or services for future consideration.

b)            Winter pressures: The current picture and plans in responding to Covid-19, and the anticipated rise in influenza and other winter-borne illnesses.

The Chair advised the Panel that Dr Ruth Charlton will not be providing the update on the future of Epsom and St Helier University Hospital Trust at this evening’s Panel. This will be covered at the Panel in March 2022 by the newly appointed CEO.

Dr Charlton advised that at the present, and as anticipated, the Trust is managing:

·                     An increase in Covid cases alongside the normal winter virus.

·                     A surge in virus in children

·                     Its recovery in respect of planned care and elective surgery. 

 Dr Charlton advised that an immediate challenge is doing this work with an already fatigued workforce.

Dr Charlton advised that during the Spring/Summer period they had seen normal levels of A&E attendance however since this time, the numbers of presentations have steadily increased up to 250 patients a day. This is compounded by the fact that such high numbers cannot be accommodated in the building.

However, of some reassurance, the number of patients they need to admit is not increasing.

In terms of Covid, the numbers fluctuate with Epsom and St Helier currently having 52 patients admitted with Covid. Dr Charlton advised, however that routine testing of patients has commenced, and therefore Covid is not always the primary reason for admission. The numbers in critical care are now small and this is largely due to the vaccination rollout.

In planning for winter pressures this year, what has changed is the level of collaborative working and that the Covid response would not have been as successful without partnership working. Additional funding is available this winter, however it is workforce fatigue that presents the greatest challenge.

Dr Charlton advised the Panel on the new ways of working in respect of linking in with other partners and Trusts, assessing the availability of beds and getting an understanding of the situation across the hospitals. Working as a system has been and continues to be instrumental in managing the pandemic.

There continues to be a lot of modelling in respect of the provision needed. It is difficult when no-one knows how the pandemic will change, or how the vaccination programme will continue to impact. Epsom historically plans for 6 critical care beds, and St Helier 13. It is anticipated that the beds at St Helier may need to increase to 22 beds.

In respect of winter investment Dr Charlton touched on the following matters:

·                     Point of care Covid PCR testing and investing in a rapid PCR testing machine to help identify Covid at the earliest convenience.

·                     An increase in hospital porters. Dr Charlton advised that the new layout of the hospital to accommodate Covid patients has  ...  view the full minutes text for item 13.

Emma Cox (Associate Director of Delivery – Surrey Downs and Health and Care Partnership) and Dr Hilary Floyd (Co-medical Director Surrey Downs and Health and Care Partnership) presenting on the following at 7.45pm

•           The work of Surrey Downs Health and Care Partnership, and the place-based activity that looks to support our local communities in addressing the wider determinants of health

•           An overview of the Pulling Together Programme and the agenda for change in partnership working

The Panel received a presentation on the following matters:

a)            The work of Surrey Downs Health and Care Partnership, and the place-based activity that looks to support  local communities in addressing the wider determinants of health.

b)            An overview of the Pulling Together Programme and the agenda for change in partnership working.

Dr Floyd followed on from the earlier presentation by Dr Charlton and advised that healthcare delivered in the community had been impactful on Epsom and St Helier Hospitals, and that during the pandemic, there had been more emphasis on community delivery.

There were lots of elements of the service that rapidly increased or developed. This was aimed at preventing people presenting to A&E and how to  speed up discharge from the hospitals by linking in primary and care and general practice to keep people at home. This has helped Epsom in respect of its bed utilising and flowing through quicker. Social Care was also vital in this delivery.

Dr Floyd talked through what Surrey Downs Health and Care Partnership is as a vehicle for bringing together all the partners that are key in delivering better healthcare and wellbeing outcomes for the population. Within this there is an emphasis on ‘place’, and an acknowledgement that these initiatives should be delivered where people live.

The partnership brings together the NHS, community partners, the voluntary sector, local government, and other providers that service the community.

The Partnerships covers Dorking, Epsom and Ewell and East Elmbridge, and a population of about 320,000 patients.

The Partnership is formed of 6 PCNs to jointly look at the needs of PCN areas to delivery better care and boost up the capacity of General Practice by delivering collectively. This will include the work of the boroughs and district and voluntary sector moving forward.

Dr Floyd talked the Panel through the Partnership board.

The Partnership has developed a transformation programme to look at how things can be done differently, especially after the pandemic. This highlighted lots of issues and it is accepted that a lot of things ‘stopped’ during the pandemic, especially elective procedures. They are now looking at re-referrals for these patients.

The issue of having an Integrated Community is a key issue for the Partnership and they are looking to integrate roles such as district nursing back in at PCN level, as opposed to a GP level. Workforce is a determining factor in this.

Dr Floyd went on to explain that a key element of their transformation programme is ‘Thriving Communities’, and that this is being driven by population health management. This seeks to understand what might be causing ill-health and a lack of wellbeing in groups of the population. Dr Floyd reflected that often decision makers think they know the answer, but this is often incorrect; a patient attending the GP with stress and anxiety will often have an underlying social/economic determinant and the programme seeks to address this.

Dr Floyd reflected on the Pulling Together event and reflected that the aim was  ...  view the full minutes text for item 14.