To receive an update from One Devon NHS on Winter Plan.

Johnathon Kelly – Director, NHS Devon and University Hospitals Plymouth NHS Trust outlined the submitted presentation in respect of the Winter Plan and responded to questions.  Key points included:

·                Focus on collaboration across providers in respect of vaccination uptake, and reducing bed-based care.

·                Monitoring trends for Covid-19, Respiratory Syncytial Virus (RSV), and flu; and considering potential early interventions (e.g. masks, additional hygiene).

·                Virtual wards discussed as a way to manage patients outside hospital beds.

·                Concerns raised about discharge practices, community-based care, and vaccination messaging.

Members asked the following questions:

·                How was the hospital ensuring patients were not discharged too early?

·                What steps were being taken to target hard-to-reach populations for vaccinations?

·                Why do some surgeries run out of vaccines?

·                How will community-based services be developed to reduce bed-based care?

·                What does a virtual ward look like?

·                What was deconditioning?

·                What was being done about RSV?

·                What was the impact of orthopaedic theatre closure, due to heating issues?  A written response would be provided.

·                GP appointments: How was prioritisation of appointments managed when waits exceed two weeks?  A written response would be provided.

·                How many people have been supported in virtual wards last year compared to this year?  A written response would be provided, including pathways and community involvement.

·                What considerations have the hospital taken to support unpaid carers?  A written response would be provided.

The following responses were received:

·                Readmission rates to hospital were monitored for 30 days post-discharge.  Risk-sharing across partner organisations helps identify anomalies and improve discharge practices.

·                Vaccination programs focus on vulnerable groups.  Councillors were encouraged to promote uptake.  Communication campaigns include social media and warm spaces.

·                There was no known stock control issue.  Vaccines were not available before 1 October, which may be reviewed for future years to provide a wider window of time to roll out vaccinations.

·                Plans included virtual wards, local hubs (e.g. Newton Abbot), and digital solutions.  A 10-year health plan emphasises community care.

·                Virtual wards monitor patients at home who need ongoing care (e.g. intravenous antibiotics).  A written update was requested on numbers supported and effectiveness of virtual wards.

·                Deconditioning was a loss of muscle mass and mobility due to inactivity during hospital stays, making recovery harder.

·                RSV vaccinations target pregnant women and young children (0–4 years).  Vaccination reduces hospital admissions by up to 75%.

Resolved (unanimously):

1.       that all Councillors promote and encourage people to take up vaccinations particularly the elderly and vulnerable people and help to identify new groups that may reach into underserved groups and to encourage the use of pharmacy first, 111 and the NHS app;

2.       that the ICB be requested to provide wider communication including via social media, via warm spaces etc. to encourage take up of vaccinations;

3.       that the Torbay and South Devon NHS Foundation Trust (the Trust) be requested to provide a written update on virtual wards, which have been talked about for a number of years, how many people did we support in a virtual ward last year compared to a previous year and how many do we expect to be supported this year.  When will we know it is working well, are there some pathways that are better, what conversations are being held with the community and voluntary sector to assist with this;

4.       that the Trust be requested to provide assurance that bed based discharge and bed based avoidance will not be the only focus over the winter and details of what action they are taking to stand up additional therapy support and other appropriate support to enable people to remain at home and receive support in the community; and

5.       that the Winter Director, NHS Devon and University Hospitals Plymouth NHS Trust be requested to share the data slides with Members of the Sub-Board and also provide the Clerk with relevant data slides which can be shared publicly.