Issue - meetings

The Chair welcomed Dr Amanda Doyle, GP and Integrated Care Strategy lead for Lancashire and South Cumbria and Kevin McGee, Chief Executive for East Lancashire Hospitals Trust and Blackpool Teaching Hospitals NHS Foundation Trust. A report was presented regarding the local NHS response to the Covid 19 pandemic.

The following points were highlighted:

·  There had been a national and local change of governance arrangements, following the declaration of a level four healthcare incident by NHS England. This resulted in NHS England taking control of all healthcare resource. A local governance structure was put in place to oversee local implementation.

·  Phase one was the initial emergency response, involving planning for and managing the impact and subsequent increased demand. The actions at this stage included stepping down non-essential work. The governance arrangements were divided into two cells - hospital and out of hospital, both of which included a range of leaders who worked closely with the Local Resilience Forum (LRF) to effectively manage decision making. Some programme work regarding system development, transformation and commissioning reform had been adjourned in order to focus on the incident.

·  The hospital cell co-ordinated the work of the main hospital sites across Lancashire to support the initial surge of Covid patients, concentrating on increasing capacity for critical care and beds. The considerable numbers that had been initially forecasted for critical care were not realised. The additional requirements for personal protective equipment (PPE) had been met through mutual support across the cells and working collectively as a system.

·  The initial phase required moving staff to support the most urgent areas and this necessitated some temporary service changes to ensure service quality and the deployment of staff to the most urgent areas such as respiratory care and A&E. This included the temporary closure of Chorley A&E, the birth unit at Blackburn and the minor injuries unit at Blackpool. These clinical decisions had to be made quickly and the decisions were communicated widely with stakeholders and the public, emphasising that they were temporary measures required to respond to the crisis. Any permanent change would follow the statutory guidance and fulfil the required engagement process. Other changes included significant visiting restrictions, following national guidance to support infection control. The cell continued to work closely with LRF and other bodies to ensure changes to public services were publicised. This way of working enabled new best practice to be established in terms of sharing data between organisations in a controlled way, which facilitated improved communication and action.

·  The work was now moving toward restoration of services and taking learning points from good practice joint working to develop future practice. There had been a significant reduction in Covid 19 patients across Lancashire, however the hospitals were prepared in terms of capacity for any future surges in cases. Planning for winter was in progress alongside focusing on cancer and diagnostic activity. It was noted that restoration work would be implemented in a planned and considered way to take into account the need for  ...  view the full minutes text for item 4