Agenda item

Mr Gary Collier, the Council’s Health and Social Care Integration Manager, highlighted three particular aspects of the report: NHS recovery and planned care backlogs and their implications; the Covid 19 vaccination programme; and workforce issues. 

Insofar as the vaccination programme was concerned, the Board was advised that it was proving increasingly difficult to convince residents to complete all three of the available vaccinations.  Mr Collier also highlighted the Government’s decision to revoke the requirement for care staff in regulated care settingsto be vaccinated and the Board was advised that any impact on the care sector of this action would be monitored, and any implications reflected in future performance updates.

Mr Edmund Jahn, Chief Executive Officer at Hillingdon GP Confederation, noted that an announcement had been made ten days previously that there would be a further six months of planned vaccinations using PCN community vaccination centres.  Although a low volume of vaccinations were currently being delivered at the fixed and flexible/pop up hubs across the Borough, e.g., 100-150 vaccinations were being given each day at Mead House, Winston Churchill Theatre and pharmacies, there would be a move to provide those aged over 75 and care home residents with a fourth dose.  If Mead House was retained in the south of the Borough and only pop up hubs operated in the north, there would be capacity to cover the additional demand.

The Board was advised that there was a national shortage of staff, particularly in care homes.  A number of initiatives had been detailed in the report to try to address this workforce shortage.  In addition, the North West London (NWL) Business Intelligence Unit was developing a system to collect data on care home related hospital attendances and admissions.  This would allow partners to undertake targeted work with the care homes.

Ms Kelly O’Neil, the Council’s Interim Director of Public Health, advised that her team commissioned the NHS health checks in the Borough and that consideration needed to be given to what happened after someone had had a health check (the “so what?”).  Further information on this issue would be included in a future performance report to the Board. 

The report set out key performance indicators in relation to the length of stay of Hillingdon residents aged over 18 for 7+ or 14+ days in Hillingdon Hospital.  It was noted that those who had longer hospital stays tended to be older which meant that it was important to continue with the Discharge to Assess (D2A) initiative.  Although this information was not currently broken down by age, this could be done.  More needed to be done to work with colleagues in other Boroughs to quickly identify people’s needs and ensure that they were given the right support to meet those needs. 

Ms Patricia Wright, Chief Executive at The Hillingdon Hospitals NHS Foundation Trust (THH), advised that, at a national level, there had been a push in relation to discharge management.  A package of indicators had been adopted by approximately 16 Trusts to look at issues such patient flow through the hospital and admission avoidance improvements.  D2A had resulted in improvements but it was clear that more could be done, and that further focus was needed on prevention rather than reaction to deal with an increasingly complex cohort of patients.  Consideration would need to be given to segmenting the data to target relevant patients (which was one benefit of working at place level). 

The Board was pleased to see that the end-of-life dashboard had been developed and that Hillingdon was enabling residents to achieve their wishes about preferred place of death.  Compassionate Hillingdon had also been adapted from a ‘Compassionate Neighbours’ model and introduced.  Dr Johal advised that Hillingdon had pioneered ‘Coordinate My Care’ which was an advanced care planning tool which also included information about preferred place of death.  It was anticipated that this dashboard would provide partners with dynamic data which would shape care in the Borough.  Some data from the dashboard had been included in the performance report and a further update would be included in the report to the Board’s next meeting.  With the ‘Coordinate My Care’ due to end, it would be important that any future system provided continuity.  Dr Johal advised that the facility would remain as was but unbadged for the next six months and then the new system would be introduced once ready. 

RESOLVED:  That:

1.    further information in relation to action taken after health checks had been undertaken be included in a future performance report to the Board; and

2.    the report be noted.