Decision details

Karen Partington, Professor Mark Pugh, Andy Curran and Karen Swindley from Lancashire Teaching Hospitals Trust (LTHT) and Helen Curtis from Chorley South Ribble and Greater Preston Clinical Commissioning Group provided a presentation (appended to the minutes) to the Committee on the Emergency Care Update.

The presentation provided a response to the recommendations contained within the 'Emergency Care Crisis – Chorley' scrutiny review report and included an update on the progress on the Chorley Emergency Department mobilisation plan.

It was confirmed that the issues concerning Accident and Emergency (A&E) departments has been mirrored nationally with increasing attendance and deteriorating performance levels.  Added to this was the difficulties to discharge patients for a number of reasons although it was reported that LTHT were working with partners to assist with this.  In addition, a programme was reported to be in place to identify other support services to assist with alleviating the numbers of patients attending A&E.

It was highlighted that although a number of CV's were received since April for the required middle grade doctor vacancies, a large number of these did not meet the required criteria.  In addition, although 12 job offers were made, none were accepted, largely due to doctors accepting job offers elsewhere (mainly in the south of England).

Members were assured that NHS Improvement provided assistance with the concerns raised around the inconsistencies in the application of the agency cap across hospitals.

It was confirmed that the Urgent Care Centre will be mobilised on the 18 January 2017.

Members of the Committee were invited to comment and raise questions and a summary of the discussion is set out below:

It was confirmed that applications were regularly received from all over the world and from doctors who have never worked in the UK before or worked in the NHS.  Many were applying for large number of posts across the UK.  Further to this, members were informed that a large number of applicants were required to pass the English language test. It was reported that support is given to applicants through the international recruitment process and that the language skills element is part of this scheme.

It was agreed that there was a need to ensure Lancashire is recognised as attractive place to work and this is currently being addressed with various partners.  It was confirmed that a great deal of information at a local level was being providing to overseas applicants but the feedback received indicated that pressure was from the applicant's families to move south.

It was reported that there has been no current impact in Lancashire post Brexit but were looking ahead for any future implications particularly around international recruitment.

Members questioned the confidence in staffing numbers being available for January 2017 opening and it was reported that the Urgent Care Centre would be run by Go To Doc which is a not for profit organisation who will provide their own staff.  This would release the staff currently providing this service to support the 12 hour A&E.

A query was raised in relation to the reported 'super hospital' and members were advised that work was currently ongoing to identify what the NHS would look like in the next 10 years and the redesign of services.  There were reported to be no plans to specifically look at providing new hospitals but that the new model of care linking health and social would determine the location of services.  In addition, there would be work completed around local need through the public engagement programme. 

It was confirmed that education is a key partner and will be part of Our Health, Our Care programme.  In addition, from the NHS perspective, there continues to be a need to improve the pathways and communicating those effectively. 

In response to the query around the 2012 reduction in training places, it was highlighted that Health Education England commission training places and have regularly monitored the situation.  It was reported that there is a shortfall of around 3000 nationally out of a total of 8000 nationally required. 

In response to the query around the future of Chorley Hospital, it was confirmed that the flow of patients into the medical admissions unit has remained.  The same range of services in Chorley Hospital continues with a new Chemotherapy Unit in place.

Members were assured that there was a mobilisation and communication plan in place which could be shared as a narrative with the Committee.

Members were advised that in neighbouring hospitals (particularly Wigan and Preston) there has been only a small increase in activity reported.  Members queried this information and it was confirmed that this information was received direct from the other hospitals. 

A query was raised in relation to winter planning and it was confirmed that plans were in place to manage this.  In addition, the opening of the Emergency Department and Urgent Care Centre at Chorley Hospital will help to relieve some of the pressure.

In relation to a question on major incidents, it was reported that a major trauma network event was held to look at this and it was recognised that there have been significant changes across major trauma networks and plans would need to be updated in line with these changes. 

Members then discussed the request for a decision on the signage and whether it should be updated to convey that the Emergency Department at Chorley would only be open for 12 hours per day.  Members were advised that there were no issues with the current signage.  Members agreed that further conversations would be required and that additional information would be circulated.

Resolved: That;

1. The response by the Trust and comments from the Committee be noted

  ii.  The Communication and Engagement Plan from the Trust be provided to the Committee on the Emergency and Urgent Care Centre

  iii.  An update be provided to the Committee in February from the Trust on the progress of the revised Chorley Hospital A&E and Urgent Care Centre provision