Home > Council and Democracy > Agenda item


Agenda item

WHOLE SYSTEM TRANSFERS OF CARE SCRUTINY REVIEW

To update the Committee on the implementation of the recommendations made by the Committee following the final report and recommendations of the Whole System Transfers of Care Scrutiny Review.  

Minutes:

Ms Berenice Groves, Interim Director of Operations for Unscheduled Care, Blackpool Teaching Hospitals NHS Foundation Trust (BTH) and Mr Peter Murphy, Director of Quality Governance, BTH presented the Integrated Care Partnership’s response to the recommendations made in the Whole System Transfers of Care Scrutiny Review. Ms Groves highlighted that hospital performance had improved in the winter of 2018/2019 in comparison to previous years citing increases in meeting the four hour standard measure of wait time in the emergency department and a fall in non-admitted breaches.

 

The Committee considered the response to each recommendation of the review in detail, asking questions regarding implementation and determining whether further information was required or if the recommendation could be signed off as complete.

 

The Committee agreed:

 

Recommendation

Action/update

Next steps

One – To consider introducing a policy to limit the number of family and friends attending the emergency department.

 

A policy had been introduced as per similar policies on the wards. Clinicians were also allowed to use their discretion in implementing the policy dependent on the severity of the illness or injury of the patient.

 

Completed.

Two – To review extended access appointments to look at usage, the reasons why the service was not more widely used and how to improve the use of appointments.

A review had been undertaken and take-up had been improved, however, there remained unused capacity. Members of the Committee also provided additional anecdotal evidence to suggest that not all GP surgeries offered extended access appointments as a matter of course. Mr Roy Fisher, Chairman, Blackpool Clinical Commissioning Group highlighted the ongoing work to improve the offer of the appointments including undertaking a mystery shopper exercise. He advised that work was ongoing to ensure practice was embedded.

Completed.

Three – To explore the impact of delayed receipt of prescriptions from the pharmacy on discharges from hospital and identify a course of action to address the delays.

It was noted that further work was required to roll out identified improvements across all hospital wards. A number of wards had been trialling different approaches and the use of Ward Pharmacy Technicians had proved positive. Members highlighted a number of issues with dispensing of prescriptions which demonstrated that further improvements were required. It was also noted that the discharge lounge, where patients could wait for prescriptions, had recently started operating seven days per week.

Members were of the opinion that further work was required on the recommendation and requested a further response in approximately six months.

Four – To identify ways to offer facilitated parking for discharge staff.

It was reported that this recommendation had been the hardest to achieve and that it had been an ongoing issue for a number of years. However, it had now been resolved and Mr Les Marshall, Head of Adult Services reported that staff had been appreciative of the resolution and productivity and efficiency of discharges had improved as a result.

Completed.

Five – To review discharge processes to ensure they are efficient, effective and to identify if any parts of the process could be carried out once a patient had left hospital.

Ms Groves highlighted that a number of pieces of work relating to improving discharge processes were ongoing. It was noted that each piece of work would be tracked with data to determine if it had impacted on performance. It was also noted that there had been a reduction in the length of stay of patients and the impact of the bed reduction pathways which could be shared with the Committee.

Members requested a further update on the impact of the initiatives to improve discharge processes in approximately six months.

Six – To work to improve communication with care homes.

Ms Groves reported that the Executive Director of Unscheduled Care had arranged to meet with the Chair of the Blackpool Care Home Provider Forum. An issue had been identified with care home staff being requested to remain in the emergency department with their resident and work was ongoing to ensure that all emergency department staff recognised that the duty of care for the patient had transferred to the hospital and that care home workers could leave if they needed to return to the care home.

Completed.

Seven – To utilise social media to send out alerts relating to emergency department waiting time, walk in centre waiting time and available GP appointments on a day.

The Trust had highlighted a number of issues with the recommendation, most notably suggesting that patients who needed to attend the emergency department being reluctant to do so due to the publicised wait times.

Upon further consideration, Members decided to withdraw the recommendation.

Eight and Ten – To install signage at an appropriate point to the car park entrance alerting people to current waiting times and to consider how available marketing signage around the town could be used to promote positive NHS messages.

An overview was provided on the various ways in which signage was being utilised and Ms Groves updated the Committee to advise that the Trust was currently looking at putting in place signage at an appropriate point near the car park following discussions with colleagues at Lancaster Royal Infirmary who had implemented a similar action. It was noted that partners were working together and producing a joint communication plan.

Completed.

Nine – To consider offering parking refunds to patients attending accident and emergency inappropriately.

It was reported that consideration was being given to the first 30 minutes of parking being free, in order that patients who had inappropriately attended the emergency department could then leave immediately without facing a parking charge. The Committee suggested that consideration also be given to providing free parking tokens for people picking up patients in order to further speed up their discharge. Furthermore, it was considered that the Trust should also explore the costs of parking for low income families, cost of parking for families of patients who were admitted for a prolonged period and how widely refunds for parking for certain services such as maternity were advertised.

The initial recommendation was agreed as completed. Ms Groves was requested to respond to the additional recommendations in approximately six months.

 

 

 

Supporting documents: