Agenda item

To consider the mid-year performance of the Blackpool Clinical Commissioning Group (April 2020 – August 2021) and also a more in depth look at the impact of the COVID-19 pandemic on current performance and ongoing recovery planning.

Ms Jeannie Harrop, Head of Commissioning, Blackpool Clinical Commissioning Group (CCG), Ms Janet Barnsley, Executive Director of Integrated Care and Performance, Blackpool Teaching Hospitals NHS Foundation Trust (BTH) and Dr Neil Hartley-Smith, Executive Clinical Director, CCG, presented the Blackpool Clinical Commissioning Group Mid-Year Report (2021/2022).  Ms Barnsley reported that since the last report long-term waiting for patients had reduced, although figures remained high, and cancer referrals had increased. The North West Ambulance Service was also reported as having experienced reduced levels of performance.

The Committee noted that the performance monitoring report included many instances of performance marked in red, indicating that targets had been missed. It was therefore queried how the Accident and Emergency department (A and E) was coping, in light of increased levels of Covid-19 and the challenging winter period. Ms Barnsley replied that the department was undergoing a challenging period and that delays in discharge caused by local Adult Social Services not having care packages in place had added to pressures being experienced. She also added that there had been an increase in the acute nature of people presenting to A and E which had resulted in an increase in admissions. Dr Hartley-Smith stated that, where appropriate, people were encouraged to use alternative health services and that a system was in place to filter out people who did not require emergency treatment on presentation. He added that efforts were being made to increase discharges but that recruitment issues in social care had made this challenging, combined with the ongoing increase in Covid-19 cases presenting at A and E.

The Committee discussed the demographics of breast cancer screening in Blackpool, noting that regular screening was offered to women over the age of 47, but that cancer could affect women much younger than this, with early diagnosis often leading to improved outcomes. It was queried if the screening age could be lowered if insufficient women came forward from the 47 years old and over group and if lower age groups in specific areas could be targeted. Dr Hartley-Smith advised that breast cancer screening was offered to older age groups because cancer tissue was more visible on breast scans in older women. In younger women scans were less effective in identifying cancer and could provide false reassurance. He therefore stated that rather than lowering the age for scans, that all women should regularly undertake self-examination and contact their GP if they had concerns.

The level of face-to-face appointments available to patients at GP surgeries was queried by the Committee, with Members noting that for some people telephone or online appointments were not appropriate. In response, Dr Hartley-Smith informed the Committee that all surgeries should be triaging patients’ appointments based on individual need.

Members queried if ambulance crews had been trained to determine if individuals should be admitted to A and E. In reply to which Dr Hartley-Smith stated that from the initial emergency phone call a patient was assessed to determine the best course of action. Each ambulance crew also included a paramedic who was capable of treating patients at home and the crews had access to support to determine if it was necessary to take someone to a hospital.

Access to A and E and other hospital wards by relatives and friends was also discussed, with the Committee expressing concern that the visitor policy appeared to change unexpectedly and prevent access. This had the potential to cause distress to both the family and patient and could be detrimental to their health. Ms Barnsley recognised that changing visitor guidance was a challenge for visitors and for hospital staff to enforce, but stated that the policy was subject to national guidance which could change in response to Covid-19 levels. She added that the concerns of the Committee would be noted when considering any further changes to the policy.

The targets set out in the report were questioned by the Committee, asking if they had been set locally or nationally and how Blackpool compared to similar authority areas. Ms Barnsley replied that the targets had been set nationally and that whilst details of other areas’ performance were available online, she could provide the Committee with a summary of performance across Lancashire for comparison.

Members of the Committee were informed that a Covid-19 vaccine would be mandatory for all front line NHS staff from 1 February 2022, in response to which Members questioned what the response from staff had been. Ms Harrop responded that 95 per cent of staff had received the vaccine and that contact had been made with the remaining five per cent to ensure that all staff could make an informed decision regarding the vaccination.

The Committee raised the issue of those who had taken part in the Nova Covid vaccine trail in Blackpool. As this vaccine had not been accepted for use by the NHS it had meant that those who had been vaccinated as part of the trial were unable to demonstrate vaccination status as part of any Covid passport requirements. Ms Barnsley responded that individuals who had received the Nova vaccine would be offered a Pfizer booster vaccination. She agreed to check how those who had received Nova could demonstrate their vaccination status and offered to share the details with the Committee.

Members thanked those in attendance for the report and asked that it be noted that while the CCG faced significant challenges, positive progress had been made in a number of areas.

The Committee agreed:

1.      That the concerns expressed regarding the visitor guidance would be noted by the CCG in the event of further changes to it;

2.      That a summary of CCG performance across Lancashire be provided to the Committee to allow comparison; and

3.      That Ms Barnsley would check how individuals who had received the Nova Covid-19 vaccine could demonstrate their vaccination status and provide details to the Committee.