Agenda item

To consider the mid-year performance of the Blackpool Clinical Commissioning Group (April 2018 – September 2018).

Ms Kate Newton, Performance and Quality Manager, Blackpool Clinical Commissioning Group (CCG) presented the mid-year performance of the Blackpool CCG from April 2018 to September 2018 to the Committee highlighting that a number of indicators had been negatively impacted by a shortage in consultant radiographers.

Mr David Bonson, Chief Operating Officer, Blackpool CCG added that the impact of Winter 2017/2018 could be seen in the performance reporting for the first two quarters of 2018/2019, and that it had taken services longer than expected to recover. He added that performance had been improving since September 2018 and that Accident and Emergency performance was currently 90%. A new winter plan had been developed and it was considered that its implementation was already having a positive effect on performance.

The Committee discussed the recruitment and retention of staff, especially those in niche areas such as consultant radiographers for breast cancer. It was noted that the performance of the indicator ‘patients seen within two weeks of a GP referral for breast cancer symptoms’ was 25.18%..

Members were extremely concerned with the poor performance for referrals for breast cancer and considered the level of performance to be unacceptable. In response, Mr Bonson advised that In order to see patients more quickly support had been sought from other CCGs within Lancashire, however, no consultants had been willing to travel to Blackpool to provide a service and the only appointments offered to Blackpool residents were in Burnley. He added that a locum radiographer had subsequently been appointed in Blackpool and it was expected that the performance of related indicators would improve.

Members further queried if transport had been offered to take patients to Burnley to increase the likelihood of them accepting an appointment so far away. The CCG representatives at the meeting were unsure if had transport had been offered and agreed to investigate the matter following the meeting.

Further concern was raised with regard to succession planning. It was noted that a number of services were provided by specialists and were reliant on individuals and small teams. Mr Bonson advised that a regional approach must be taken to ensure the ongoing provision of such specialist services. It was requested that the CCG report back to the Committee in July 2019 looking at the main areas of concern with succession planning and an approach to be taken.

With regards to the Winter Plan for 2018/2019, Mr Bonson advised that a more robust approach had been taken than in previous years and programmes put in place would be managed and monitored extremely closely. He added that the plans put in place would also ensure that services would be more capable of dealing with the extra pressures and reacting accordingly.

The Committee went on to consider the number of patients waiting for more than 12 hours in Accident and Emergency and noted the large proportion of patients that were mental health patients. Ms Newton advised that the figures also included patients arriving at Accident and Emergency intoxicated with alcohol and/or drugs. She reported that before an intoxicated patient could be assessed they must detox which took time and added to the length of wait. Members requested that future data demonstrate the number of patients experiencing a 12 hour wait due to attending the emergency department with drug and/or alcohol intoxication.

Reference was made to the indicator ‘patients receiving definitive treatment within one month of a cancer diagnosis’ and the decreased performance from the end of year data presented to the Committee in July 2018. Ms Newton reported that the same delays in treatment were being experienced across Lancashire due to a shortage in oncology capacity. Members were advised that the target was expected to be met by the end of the year. It was also noted that due to the small numbers of patients being treated the change in percentage performance appeared more severe.

The Committee agreed:

1.      That the CCG investigate whether transport was offered to patients to attend appointments outside of the area and report back to the Committee.

2.      That the CCG report back to the Committee in July 2019 with the main areas of concern in relation to succession planning and an approach to be taken.

3.      That future data demonstrate the number of patients experiencing a 12 hour wait due to attending the emergency department with drug and/or alcohol intoxication.