Agenda item

Andrew Bland, NHS Southwark Clinical Commissioning Group (CCG) will present on performance of local Accident and Emergency departments.  

A performance report from the CCG and a briefing from King’s College Hospital (KCH) is attached.

5.1  Andrew Bland, Southwark Clinical Commissioning Group chief officer introduced him and presented the report circulated with the agenda. The chair invited questions.

5.2  A member remarked that there was nothing in the report about re-admissions, and requested these figures. The Chief Officer reported that these are Monitor and can be provided, however he reported that it is not an area of concern.

5.3  The Chief Officer was asked to clarify if more A& E capacity is planed to meet demand and he said that with a heavy heart the CCG are increasing acute capacity, however more of that will be at home. There will be a growth in bed capacity as if the CCG did nothing there would be an 80 bed under capacity at Denmark Hill - but capacity will be increased by increasing at home provisions and repatriation.

5.4  A member referred to page 16 of the report and the staffing issues highlighted. The Chief Officer said this was an issue, and he could provide more information, bit it was not a significant driver.

5.5  Members asked for reassurance that people could still choose their preferred locations for elective care and the Chief Officer assured the committee that there is still choice in Southwark. He reported that he went to the new King’s College Hospital (KCH) out of borough sites in Orpington and Princess Royal University Hospital (PRUH) and people are very positive about the elective care they receive there; these are very short stays of 0.75 days. He remarked that the demographic of Southwark is very different than around PRUH, with a much older population in Bromley.

5.6  Members asked why repatriation is such an issue and the Chief Officer explained that  King’s ( Denmark Hill KCH site ) is a  specialised trauma centre serving a wide area.

5.7  Cllr Jasmine Ali raised Patient Voice and suggested that this is used more to access quality. She offered to follow up on this. The Chief Officer mentioned Friends and Family feedback as a tool to assess patient experience.

5.8  The chair invited a member of the public to speak in the audience. Tom White remarked that the report is excellent until the point where it talks about mental health. He voiced concerns that patients are only seen by nurses and remarked that there are 300 patients turning up at King’s and asked why Maudsley can not open its doors to emergency patients . The chair remarked that scrutiny had recently done two reports that had looked at access to mental health, one of which had gone to the GLA. The Chief Officer remarked on the scale of the problem King’s are facing with unprecedented spikes of 600 to 800 patients a months, with 300 being an average. Eleanor Batement, Service Director, SLaM said that there are two psychiatric nurses are on duty day and night at King’s, and they are employed by SLaM. People are also admitted to SLaM (Maudsley and other sites) and they have provided more beds. The Chief Officer said that there is a changing level of demand and rising pressures, he said there is a high level of concern in the CCG, however he thought the measures planned would help. 

5.9  A member asked if A & E was better served under the old system and or the new and asked the Chief Officer to identify the challenges. He remarked that this was the first time he had worked for a boss (the GP chair of the CCG) who took shifts in A & E to see how it worked. The new arrangements of commissioning through the CCG, rather than the PCT, mean a reduction in the budget under his control – the CCG only has two thirds of the old PCT budget. He commented that many of the challenges lie outside of the CCG – with housing and local care services and there will be a continuing focus on local issues going forward. The member thanked him for his helpful comments, even if they did not exactly address the question. The Chief Officer agreed, and pointed out that given his position this was difficult to do.

RESOLVED

The CCG will provide information on KCH and GST emergency ward  :

• Re-admission rates
• Staffing levels and any issues