Agenda item

Report of Borough Director Harrow Mental Health.

The Sub-Committee received the Harrow Health and Care System Pressures report from the Managing Director Harrow Borough Based Partnership.  Which provided an update on demand and activity in the Harrow Health and Care system during the winter period and progress on the measures planned by the Harrow Partnership to meet them.

The following keys points were reported on during the presentation:

·                 Pressure on the health and care system had peaked during the first week of January, when the post-Christmas surge in presentations and the Junior Doctors’ strike impacted simultaneously.

·                 A&E attendances now averaged 2,170 per week, an increase on last winter’s average attendance and a level that, pre-Covid would have been an unusually high peak in demand.

·                 Non-elective admissions to Northwick Park Hospital averaged 600 per week, as high as during the previous winter.  Admissions peaked in the week before Christmas at 718.

·                 London Ambulance Service handover delays had reduced following stricter limits being placed on the time that ambulance crews would support patients at the hospital before handing over to A&E staff.  One consequence of this had been an increase in long waits in A&E: the number of 12 hour waits in A&E had averaged 395 per week since October, compared to 313 during the previous winter.

·                 During November and December an average of 97% of beds were occupied; in addition, patients were routinely being ‘boarded’ i.e., managed on wards before beds became available for them.

·                 The number of people on social care caseloads post-discharge from hospital was now three times that in the pre-Covid period.

·                 Although health and care staff in the hospital and community, including primary care, had coped during this period it was necessary to acknowledge and address the impact on patients, staff and services working under this level of pressure.

Following the presentation, the Sub-Committee made comments and asked questions.

·                 Concerns were raised about the impact of the junior doctors strike on elective care and the stress experienced by staff.  It had affected elective care and planned procedures, but emergency and cancer care were not significantly impacted.

·                 Clarification was sought on what was meant by boarding. – and it was explained that Patients were offloaded from ambulances into corridors with clinical oversight until officially admitted, it was not ideal but allowed the ambulances to respond to other emergency calls.

·                 The 12-hour waiting time in A&E had not reduced since the last report and Members questioned why this was and commented that in neighbouring boroughs, the wait time was considerably less. – Northwick Park Hospital was the busiest hospital in the country and people from other different boroughs used this hospital.  48% of people who used the hospital were from within Harrow Borough and the reminder from neighbouring areas.

·                 The community services staff sickness rates had increased, and members questioned the reason for this and was there support in place if the absences was off due to stress. – The Sub-Committee was advised the sickness was averaging 3.9% and this period it had reduced to 1.1% which was over the winter period.  The previous period was due to flu, colds, sickness bugs the usual trend and not stress related.

·                 Members questioned what measures had been put into place for long-term planning and increased demands. – It was reported that there was ongoing evaluation on additional discharge funding and work on a long-term strategy to meet demand sustainably.  There were a number of new schemes like the bridging care service and the up take on these had increased significantly.

·                 In response to a question as to whether GP access and walk-in centres would help take the pressure off A&E, primary care access was important but walk-in centres haven’t shown a clear correlation with reducing A&E attendance.

RESOLVED:  That the presentation be noted.