To receive an update from the Trust.

The Committee received an update from the Trust.

Mr T Tomlinson, Director of Nursing and Operations, presented the report.

He highlighted the following points:

·         A continued reduction in the delayed transfers of care to the lowest level ever reported to the Committee. 

·         An increase in the number of emergency patients that had led to a high number of elective surgery cancellations, although urgent cases and cancer cases had continued to be treated.

·         Performance against the 18 week access target, that had been retained as a local target, would decline because of cancelled surgery, A recovery plan was being developed to return performance to the previous 99% achievement.

·         Infection control measures were proving effective, reducing the need for ward closures.  This had helped in meeting the increase in the number of patients admitted as an emergency.

·         Improvement actions had been implemented on Stroke care.

·         There was good progress on the development of the Macmillan Renton Unit.

In discussion the following principal points were made:

·         Concern was expressed at the report that 11.4% of patients admitted with Stroke had arrived at a time when thrombolysis was not available.  Mr Tomlinson reported that the service, which was not clinically appropriate in every case, was currently available in Hereford from (8.30 am to 6.00 pm) Monday to Friday because there was only one specialist Stroke Consultant.  Action was being taken to draw on support from other consultants and increase the number of physicians able to provide thrombolysis.  This would begin to provide cover 7 days a week.

·         The development of Hillside Intermediate Care Centre to operate as a Stroke Rehabilitation Unit alongside the continued provision of intermediate care was questioned.  It was noted that re-enablement beds were available in the Community Hospitals at Bromyard, Leominster and Ross-on-Wye.  However, Members were concerned that this provision did not meet the needs of residents of Hereford City.

Mr Tomlinson commented that the provision of a specialised stroke rehabilitation unit had been considered essential.  He added that some intermediate care provision would be retained at Hillside but this would be aimed at meeting more specialised rehabilitation needs.  Some provision would also be available in Hereford hospital itself. The focus on providing re-enablement care to people in their own homes would reduce the need for intermediate care beds.

·         Asked about the incidence of flu the Interim Director of Public Health reported that to date no one who had been vaccinated had been seriously ill.  The Health Protection Agency was conducting a review of the arrangements that had been in place for immunisation in 2010.

·         The Trust’s financial position was noted and that despite funding support from the Strategic Health Authority breaking even was a challenge.  Remedial measures remained in place to improve the position.

·         Mr Tomlinson confirmed that there were no plans to delay admissions for routine operations on financial grounds.  The cancellations that had taken place had been due to pressures from emergency medical admissions as described in the update report.

RESOLVED:   That a fuller report on stroke care provision and the arrangements for the use of Hillside Intermediate Care Centre for specialist stroke care and specialist rehabilitation should be made to the next meeting, together with assurance that the needs of those who previously would have received intermediate care at the Centre would be appropriately met.