Agenda and minutes

Apologies for absence were received from Councillor Brian Crowe.  Councillor Ray Graham attended as his substitute.

RESOLVED:  That all items of business be considered in public.

It was noted that, following the Committee's meeting on 15 November 2016, representatives from the London Ambulance Service NHS Trust (LAS) would be invited to attend a future meeting to provide Members with updates on a range of issues that had been highlighted at the meeting.  Councillor Jarjussey circulated a photo of a patient transport vehicle used in Hillingdon which had "NHS working in partnership with DHL" on the side.  He noted that there had been issues with regard to the withdrawal of the service from a number of patients. 

Although Members were not concerned about NHS partners, the Committee wanted to ensure that partners were operating at a sufficient standard.  The Chairman would ensure that Ms Vicki Hirst was asked to provide a written response, setting out the issue in Hillingdon and assurances of the standard of driver training/knowledge, the type/nature of any contracts and the monitoring measures in place.

RESOLVED:  That:

1.    Ms Hirst be contacted to provide information in relation to the patient transport services; and

2.    the minutes of the meeting held on 15 November 2016 be agreed as a correct record. 

The Hillingdon Hospitals NHS Foundation Trust (THH)

Mr Joe Smyth, Chief Operating Officer at THH, advised that there had been significant activity at the Hillingdon A&E department and the number of acute patient admissions had been increasing.  Compared to the same period the previous year, A&E attendances had increased as follows:

·         October 2016: +7.6%;

·         November 2016: +20%;

·         December 2016: +19%; and

·         January 2017: +20%.

The majority of A&E attendances were self-presenters and Mr Smyth advised that Tuesday 10 January 2017 had been the busiest day ever recorded at Hillingdon A&E with 225 attendances.  In 2012, A&E (which had capacity for 165 patients per day) saw an average of 145 patients each day.  In November/December 2016, the average daily patient attendances increased to 195, and in January 2017 it had risen to more than 200 per day.  As such, THH was not meeting the 95% standard of patients being seen within 4 hours. 

With regard to blue light/Category 1 attendances at A&E, ambulance staff rang ahead to advise the hospital that they would need one of the four beds in the resuscitation department.  In November 2016, there was a 50% increase in these attendances compared with the previous year and in December 2016 there had been a 32% increase.  Over the last two years, there had been a 53% increase in the number of Category 1 attendance which had overwhelmed the resuscitation department and meant that some patients had been moved to the majors area. 

It was noted that A&E capacity was being hindered by challenges in getting patients back out of the hospital once they had been treated.  The department was thought to be too small and radical reform was needed to ensure that patients were quickly moved out of the hospital. 

Hillingdon Clinical Commissioning Group (HCCG) and THH had commissioned a review of the blue light attendances to establish whether the threshold had reduced.  However, this work had identified that 90% of attendances really were Category 1 (with respiratory factors being a major component) and 10% were 'maybes' where it had been a judgement call. 

The Urgent Care Centre (UCC) at Hillingdon Hospital dealt with different types of patients and illnesses to those dealt with by A&E and saw approximately 220 patients each day.  Mr Smyth noted that the UCC worked well with a quick patient turnaround and helped out with A&E when possible (although the UCC could not do blood or diagnostic testing). 

Patients arriving at the Hillingdon UCC/A&E were triaged by the UCC.  If the patient needed to have a blood or other test that the UCC was not able to do, the individual would need to be seen by A&E staff.  There were a significant number of patients that used A&E as a one stop shop so that they didn't have to wait for a GP appointment and then have to wait for an appointment for blood tests,  ...  view the full minutes text for item 28.

Consideration was given to the Committee's Work Programme 2016/2017.  The scoping report for the review of community sentencing was agreed.  Once the membership of the Working Group had been agreed, Democratic Services would contact the Members to arrange the date of the first meeting. 

It was suggested that, because individuals were regularly attending A&E as it was a quicker option that visiting their GP, consideration be given to this as a review topic.  This situation had resulted in A&E being overwhelmed and it was suggested that maybe GP surgeries should be replaced with an expanded A&E.  Unless the capacity of Hillingdon A&E was increased, it would not be able to cope with the increased demand on its service.  It was suggested that consideration be given to the Chief Executive and Chief Operating Officer at The Hillingdon Hospitals NHS Foundation Trust being invited to attend a future meeting to discuss this issue. 

Members were advised that the next meeting on 15 February 2017 would use a slightly different format.  The meeting would be looking at progress made with regard to CSE since the Committee had last reviewed the issue in January 2015.

RESOLVED:  That:

1.    a date be arranged for the first meeting of the Community Sentencing Working Group; and

2.    the Work Programme be noted.