To consider the Wye Valley Trust’s Winter Plan for 2025-26.

The committee received a detailed presentation from Sarah Shingler, Managing Director of Wye Valley NHS Trust, accompanied by Sarah Assinder, Associate Chief Operating Officer, outlining the Trust’s Winter Plan for 2025/26.

The principal points of the discussion are summarised below:

1. The committee welcomed the development of the National Neighbourhood Health Programme pilot and requested that a future update be provided on the progress and delivery of the programme.

2. In relation to the Discharge to Assess (D2A) process, it was noted that the entire pathway is currently under review to ensure the system operates as efficiently as possible. It was added that as the existing D2A process has been in place for a considerable time, it is appropriate to reassess it and implement a model that remains effective and sustainable for the future.

3. It was acknowledged that national targets continue to be set, and regardless of current performance, the Trust is required to establish recovery trajectories outlining how it will achieve the target thresholds. At present, Wye Valley has submitted plans addressing handover times and the Emergency Access Standard (EAS). While the Trust is committed to improving outcomes for the local population, some challenges lie beyond its control, such as delays in Powys, which have hindered progress toward EAS improvements. Discussions are ongoing with national teams regarding the EAS, and revised trajectories have now been agreed upon and are being achieved.

4. It was noted that, in relation to demand and attendances at the Emergency Department (ED), the majority of patients brought in by ambulance are appropriate for that pathway. It was also highlighted that a new process is being introduced to address patients directed to ED via NHS 111. Currently, many of these patients are automatically referred to ED, even when it may not be necessary. To improve this, a pilot pathway is being tested whereby 111 calls are diverted to the Single Point of Access (SPA) within the community. Clinicians within the SPA can then assess and direct patients to more suitable providers where appropriate.

5. In relation to partnership working with Powys County Council, it was noted that while 20% of admissions originate from Powys, these account for approximately 50% of discharge delays. The plans outlined in the presentation represent Powys’ own initiatives, rather than those of Wye Valley, and demonstrate how Powys intends to help reduce demand and expedite discharges. It was also noted that the Powys management team has become more receptive to learning from Wye Valley Trust’s approaches and exploring how these methods can be tested and supported collaboratively.

6. In response to a question regarding the need for additional capacity during the winter months and the potential purchase of empty care beds from the private sector, it was noted that when Hillside and other Discharge to Assess (D2A) capacity are at full occupancy, the Trust is required to procure additional beds from the market to maintain patient flow. However, it was acknowledged that this approach is costly, and efforts are ongoing to reduce reliance on such external  ...  view the full minutes text for item 7