Attendance from:-
Dr Mark Shapley (Clinical Chair) North Staffordshire Clinical Commissioning Group
Presentation by Marcus Warnes (Chief Operating Officer) North Staffordshire Clinical Commissioning Group. Hand outs to be circulated prior to the meeting
Minutes:
The Chair welcomed Dr Mark Shapley and Marcus Warnes, Chief Operating Officer from the North Staffordshire Clinical Commissioning Group.
The Committee received a presentation from Mr Warnes in relation to Urgent Care and Emergency Care Primary Care for which a joint Strategy was currently being prepared with Stoke on Trent Clinical Commissioning Group.
The following points and issues were highlighted:
· Issues with domiciliary care were not necessarily financial but more to do with the retention and employment of staff and their contracts (including areas such as unpaid travel time).
· There were budget concerns regarding primary care – the budget for acute services had doubled but primary care had remained stationary.
· There were issues across Staffordshire regarding meeting the 4 hour waiting time target.
· There was an upward trend regarding A&E attendances (10.3% higher than planned). This was however a national problem. The main reasons for this included self-referral - 40% in contrast to only 6% of referrals being from GPs. Approximately 40% of referrals were also from the Ambulance Service.
The Committee questioned whether the part closure of the A&E department at Mid Staffordshire General Hospital had contributed to the increased demand at North Staffordshire. Mr Warnes stated that there had been some impact but that is was not huge. Mr Warnes stated that there had been approximately 25% increase in demand from outside of the area and that repatriation of these patients could take longer as they needed to be returned to a different area with a different operating system.
Members also raised concerns in relation to the out of hours services provided from 6pm onwards once most GP surgeries had closed and queried whether this was increasing demand at A&E. Mr Warnes stated that as so many patients skipped the visit to the GP anyway this was not thought to be a major contributing factor.
It was considered that one very important area that could be improved was the process in place at the hospital, if processes could be improved to ensure that up to half of patients were seen and discharged before 1pm then they would be able to go straight to the right after care service rather than having to wait another 24 hours in the A&E. It was confirmed that this was already being looked at and was starting to be put into action.
It was also stated that work was being done in relation to the possibility of GP surgeries being open 12 hours per day, 7 days a week but in order for this to happen funding in the region of 20 million pounds would be required. Funding on GP services had remained static since 2005.
The Committee discussed the possibility of educating the public to help make them aware that in many cases they may be seen by a highly qualified and experienced practice nurse rather than having to wait to see their GP. All were in agreement that the key to solving the problem was prevention and the identification of any problems at the earliest possible stage. Members asked that Dr Shapley and Mr Warnes please let them have any ideas for Member involvement in this education
The Committee thanked Mr Warnes and Dr Shapley for the presentation and information.
Resolved: That the information be received.