Agenda item

It was noted that the NHS was entering its most challenging time of year with increasing urgent / non-elective pressures on general practice and acute care.  The Urgent Care Centre (UCC) had opened at Hillingdon Hospital in October 2013 and had anticipated approximately 160 patients each day - the UCC was now seeing approximately 300 patients each day.  Although this increase was putting pressure on the A&E department, it was not thought to be connected to the recent closures of neighbouring A&E departments.  Hillingdon CCG (HCCG) was currently undertaking analysis to try to identify the cause and was looking at undertaking more work in the community to reduce the demands on the hospital, e.g., patient flow through the hospital and discharge.

The Board was advised that the increasing demand was not unique to Hillingdon and that Harrow and Ealing had experienced similar increases.  Although there had been a nationwide increase in non-elective admissions, Hillingdon appeared to be hit harder than other areas.  

The Chief Executive of The Hillingdon Hospitals NHS Foundation Trust (THH) advised that, although the hospital had managed to achieve the four hour performance target in A&E for the last three consecutive years, there had been a 15% increase in demand in October 2014 in comparison to the same period in the previous year.  He noted that THH was looking to identify improvements in service provision and patient discharge. 

The Board was advised that the HCCG pilot project to integrate services had been progressing well.  Social Services staff were attending and participating in the process as, although the Council was not directly involved in the project, it was affected.  HCCG was looking to roll the project out in shadow form in 2015 following completion of an impact assessment being undertaken by the Public Health team on the HCCG plans. 

It was acknowledged that HCCG had been significantly underfunded by approximately £25m and that this historic underfunding had been the cause of the PCT's financial deficit.  Conversely, those PCTs that had been overfunded were now showing a surplus in their funding.  The Board was advised that HCCG had received a small correction in its current year's funding and for the subsequent year but would still be underfunded.  Despite this underfunding, HCCG had managed to reduce its deficit in 2013/2014 by £7½m but it was anticipated that there would be additional pressure on the budget during the next financial year.  It was noted that HCCG's financial position was impacting on THH and, although the savings plan was on target, this was likely to drive the Trust into deficit during this financial year. 

With regard to the development of the GP networks, Dr Goodman advised that he would provide members of the Board with a written update.  He noted that six network had been established and were of varying size - the larger networks tended to be more mature.  It was anticipated that the networks would undertake more collaborative work over the next few months to develop extended opening hours for emergency services and provide extra resources for services, such as spirometry, which would usually be undertaken in hospital.  Further services would be considered once the hubs had come on line.  

RESOLVED:  That:

1.    the Health and Wellbeing Board notes the update; and

2.    the HCCG Chairman provide the Board with a written update in relation to the development of the GP Networks.