Agenda item

To consider a presentation in respect of preparation across Rotherham Place in anticipation of seasonal pressures.

Consideration was given to a presentation by the Deputy Place Director of Rotherham Place in respect of the Winter plan response to seasonal pressures encountered by Place Partners in delivery of health and social care services. The Plan had been developed in collaboration with all Place Partners based on learning from previous years, and including learning from the Thinking Differently for Winter workshop. The Plan had been agreed through the Urgent Emergency Care Board. The presentation highlighted what will be different this year and noted anticipated challenges. Specific innovations and challenges around Winter Planning were noted in respect of acute services, community services, primary care, children and young people, mental health, and system wide approaches.

In discussion, Members expressed interest in hearing more about urgent care and the wider system efforts to promote self-help, acknowledging that children and particularly babies can become very unwell very quickly. Members wished to know more about how this self-help advice is handled and if risks had been considered in forming this guidance. The response from the Deputy Place Director noted that a thorough description of what is being done to provide guidance and give clarity to parents and carers on where to seek advice was available from a staff member who would be in touch with the detailed answer following the meeting.

In regard to workforce challenges, Members sought assurances that these were being addressed and that everything that could be done locally to provide enhancements was being pursued. Members noted that the workforce have gone through the pandemic and received quite an insulting pay rise. Details were requested around intentions of the ICB to progress incentives of other kinds. The Deputy CEO of TRFT noted that the Trust was working to implement health and wellbeing measures to support staff. This had included considering making hot meals available during the night, which has not been previously available but was being considered. Ringfenced capital was available for the purpose of supporting staff. It had been noted that staff sickness levels were up, and fatigue was evident. The Trust had observed it was a very challenged workforce at the moment.

Members requested clarification around the first primary care and health access in terms of clinicians that are available and whether this varies among Primary Care Networks (PCNs). The response from the Deputy Place Director noted that this did vary, but all PCNs were increasing their access in the way they saw fit. Additional appointment times and extended access service added capacity over the weekends and into the night.

As regards public health measures and prevention of admissions, Members requested more information around what is being done to encourage self-management of illnesses at home. The response from the Director of Public Health indicated that there was education through schools on the prevention side as well as an examination of unnecessary attendances at A&E. The findings showed that most attendances are very much necessary. There was not observed to be a proliferation of attendances associated with self-limited illnesses that could be managed at home. There was further public health work to be done in terms of preventing admissions in the first place. There were significant media and social media campaigns to get advice out through the NHS around pharmacy first approaches.

Members requested further information about what was being done by primary care to achieve admission avoidance. The response from the Deputy Place Director noted that the target nationally was for 70% of people to be seen within 2 hours. Local services were hitting around 85% through the urgent response service. A community hub was also being established locally. It was noted that referrals coming in through GPs were then triaged and passed on to the appropriate clinician. The multi-disciplinary team (MDT) approach continued striving to reduce admissions by looking at ways these may be avoided.

Members indicated a desire to know more about plans in place to deliver the work with the voluntary and community organisation sector. The response from the Deputy Place Director noted that the post was originally separate, so there was work to ensure the post can access through social prescribing.

Members requested assurances that every contact will count during the challenging winter season. The response from the Deputy Place Director noted that in terms of cost of living challenges, Age UK provided a discharge service to support all patients on pathway 0 (without support) or pathway 1 (with support such as home care). This service provides a health and welfare check, so that concerns around cost of living can be picked up. Further work through the Warm Welcome scheme and through libraries providing warm spaces was also noted. From a strategy perspective, when the Place Plan was refreshed, emerging needs around the Place would be taken into consideration, including a wider communications plan to address emerging needs.

Resolved:-

1.    That the report be noted.