Agenda item

Report of the Managing Director, Harrow Borough Based Partnership

The Board received a report which provided an update on the delivery of the planned actions set out in the Winter Improvement Plan and also set out system pressures metrics which were designed to indicate demand pressure on the Harrow health and care system and the effectiveness of the system’s response to that demand.

Lisa Henschen, Managing Director, Harrow Borough Based Partnership, introduced the report and advised that the Plan was being implemented and that whilst the system was busy, it was coping with the pressures and there had not been a need to move into a major incident.  Since the publication of the report in December, the most pressurised week of the winter had been experienced in the first week of January, partly due to increased demand and the Doctors’ strike.  There continued to be a trend of a higher level of admissions than there had been last year resulting in an increased number of people requiring support through the discharge process.  There had not been an increase in the numbers requiring social care but the number continuing to receive social care in the community had increased since last year.   She outlined the key points of the Plan including improved performance in London Ambulance handovers.  The Trust continued to look at admission and discharge performance, the bridging services and rehabilitation beds.  The vaccination programme in terms of flu and Covid had slowed, although still available, and there was now a focus on raising awareness of the mental health service offer.

Jason Antrobus, Deputy Chief Operating Officer of the London North West Health Care Trust, advised the Board that work was underway with the London Ambulance Service and wider system partners to support flow in and out of the hospital.  He explained that there had been a key focus on the Reach model and single point of access to allow primary care providers and the ambulance service to contact the hospital in advance of admission.  He reported that there continued to be an increase in the number of patients moving daily to the discharge lounge which freed up hospital beds and that the winter capacity plan was in place.  He added that all staff had been offered flu and Covid vaccinations.

In response to questions from Members, the Board was advised:-

·                 There were regular checks on capacity but it could sometimes be difficult to find an appropriate place in a care home to discharge a patient to.   Details of the numbers awaiting a care home places would be provided to Members;

·                 There were discussions underway with providers in relation to NRS contracts and the increased costs;

·                 Nationally, a Covid vaccination fatigue had been seen.  In terms of flu vaccination take up, 42.2% of Harrow’s population had received it which compared favourably to the rest of London.  Up to December 2023, 21,000 Covid vaccinations had been given across Harrow and all vulnerable cohorts had received the vaccine;

·                 In terms of staffing, whilst the Trust was actively recruiting to all posts it had been challenging and some of the delays were due to the wider system;

·                 Many of the actions within the Plan were ‘task and finish’ and further details could be provided to the Board;

·                 Provider services in Harrow had not been affected by the 30% reduction in running costs;

·                 Clarification was provided in terms of the increase in patient beds in that these were non-recurrent and located in specific bays and included additional trolleys in the surgical assessment unit.  These beds did not have access to a bed head and would be used in extreme situations when patients were in corridors.  This would assist with the offloading of ambulances.  There was a proposal to open an acute medical unit with 82 beds on the roof of Northwick Park Hospital which would be available 12 months of the year.

·                 In response to a concern expressed by a Member at the lack of availability of some medications, the Managing Director advised that she was not aware of any specific issues but would check with the local pharmaceutical office.  The Health and Care Executive met fortnightly and she would raise this with the Pharmaceutical representative.  Isha Coombes, representative of the North West London Integrated Care Board (NWLICB), advised that notification was given by suppliers if there was a shortage of a particular drug which was then communicated to GPs.

RESOLVED:  That the report be noted.