Agenda item

Winter planning/resilience plans - Update

[To receive a report on the Royal Wolverhampton Health Trust’s winter planning/resilience plans].

 

Report is marked: To Follow

Minutes:

The Chief Executive of the RWHT gave an overview of the winter planning and resilience plans.  He stated that they were currently having to revise the Trust’s plans for the winter and hoped that the new plan would be ready for the 4 December 2018.  Telford’s Accident and Emergency Department was scheduled to close overnight from the 5 December 2018.  The staffing situation at Telford’s Accident and Emergency Department was getting worse.  The additional capacity the RWHT had planned for the winter season would all be taken up by the extra ambulances arriving due to Telford’s Accident and Emergency overnight closure. 

 

The Chief Executive of the RWHT stated he was working very closely with West Midlands Ambulance Service and the Welsh Ambulance Service.  He had a meeting the following day regarding the protocols drawn up at Telford, which he did not believe were suitable for use by the ambulance service.  The protocol that had been drawn up, expected ambulance crews to take different action depending on the day of the week, which he thought would lead to confusion.  He was most concerned with patients coming in from Wales, as a relationship needed to be established with the Welsh Social Services and the Ambulance Service.  There was no provision for paediatrics at Shrewsbury’s Accident and Emergency and so they would all be coming to Wolverhampton.  He was displeased with the situation as he had predicted the situation two years ago and felt action should have been taken earlier.  He commented that his Deputy was currently at Dudley because the Care Quality Commission had some concerns about the Accident and Emergency Department.  He was of the firm view that Dudley’s Accident and Emergency Department should not close overnight as well, as this would create severe problems in Wolverhampton. 

 

The Chief Executive of the RWHT circulated an information sheet from the BBC’s NHS Performance Tracker Webpage.  In the figures for October 2018 the RWHT was currently ranked 32 out of 131 Trusts for the target of patients admitted or treated within four hours of arrival at the Accident and Emergency Department.  All the Trusts that were meeting the 95% target were specialist Trusts or Children’s Trusts, with the one exception of Luton and Dunstable. 

 

The Chief Executive of the RWHT stated that there had been a 10% increase in ambulance arrivals in the last 2-3 weeks in the Wolverhampton area.  He hoped this would reduce as it was impacting on the performance of the Trust.  A further issue had arisen with Shrewsbury and Telford Hospital NHS Trust being placed in special measures.  The Care Quality Commission had some concerns with the maternity services at Shrewsbury and Telford.  He had not removed the delivery cap in Wolverhampton. 

 

The Chief Executive of the RWHT stated that not enough doctors had been trained nationally over the last fifteen years to cope with the current NHS Structures within the country.  It was a long-term problem which would take at least 14 years to rectify.  He was pleased to report that the Vice Chancellor at Wolverhampton University had increased the number of nurses in training.  There were now 1100 Nurses in training at the University. 

 

The Chief Executive of the RWHT Trust remarked that he Chaired the West Midlands Cancer Network.  He was informing a number of District General Hospitals that they would be stopping Urology Services.  This was due to the fact that when Urologists finished their training, they did not want to work in an organisation which did not have a surgical robot.  He was of the view that there needed to be a hospital partnership chain for Dudley, Wolverhampton, Walsall and Shrewsbury and Telford.  He believed this was the only way to sort out some of the staffing problems faced by the Trusts.  The staff working in Pathology at City Sandwell, Walsall, Wolverhampton and Dudley had all transferred to his jurisdiction on the 1 October 2018.  With that transfer, there were 23 Consultant vacancies.  He had already managed to recruit 4 Consultant Pathologists earlier in the week.  

 

A Member of the Panel asked why there had been a 10% increase in ambulance arrivals at the Trust and what campaigns the Trust had to encourage people to use Accident and Emergency Departments appropriately.  The Chief Executive of the RWHT responded that the major issue was the extra ambulances arriving.  Eighty percent of people arriving at New Cross Hospital by ambulance, were out of the hospital within four hours of arriving.  This was an area which the Trust needed to work on and encourage alternative provision to hospital.  People using Accident and Emergency as a walk-in medical centre were not so much of a problem.  The Welsh Ambulance Service were very good at spending time with people in their homes to avoid the need for a long journey to Shropshire.  

 

A Member of the Panel expressed concern about the pressure that the Trust would face when Telford’s Accident and Emergency Department closed overnight.  She was concerned that residents of Wolverhampton would be adversely affected, facing long waiting times and not receiving the appropriate standard of care they deserved.  The Chief Executive of the RWHT Trust responded that the residents of Wolverhampton, benefited with New Cross being one of the four Tertiary Centres in the West Midlands.  He acknowledged the Councillors concerns and was frustrated himself as he had seen the issue arising for the last two years.  He would be working with the Ambulance Services to help manage the situation and updating some of the Trust’s working practices.  The Trust benefited from the fact that the West Midlands Ambulance Service was the only service in the country which had 100% Paramedics on all their ambulances.  They were getting to a situation where Paramedics in the future would bypass the Accident and Emergency Department and go straight to the correct department such as X-Ray.