Report and presentation attached.

BHRUT officers explained they wished to work collaboratively with partners in order to give advice to local residents on where to get the help they require. Lessons had been learnt from last winter it was accepted that the Trust’s main challenge concerned workforce sustainability with shortages of GPs, therapists and children’s nurses.

Cross-system working was important in dealing with winter pressures with for example increasing rates of flu vaccination a priority and all partners were involved in the A & E Delivery Board. Officers accepted that there were significant pressures and but that services provided were still safe. It was noted that approximately 60% of patients brought by ambulance were not in fact admitted to hospital and had their care provided in other ways. Work was in progress investigate why people were brought by ambulance if they did not need to be admitted to hospital.

Key challenges for A & E included the rising number of ambulance patients, more admissions and the increased demand for paediatric cases. Space constraints in the hospital were also an issue. The A & E department was funded for 18 consultants and there were now 14 permanent consultants employed. Agency and locum staff were used for other acute physician roles. The previous day, A & E at Queen’s had seen 621 patients - the highest figure in London. More patients were now seen within the four hour target although it was accepted that overall figures for this remained low.

The Trust was addressing issues by initiatives such as the ‘red to green’ project which looked at the progress of each hospital patient individually. A joint project had also been started with the North East London NHS Foundation Trust which sought to reduce admissions by ambulance and provide more support in the community.

Funding had been received to expand the Raid Assessment and Focus Area at Queen’s A & E and this work was scheduled to completer by 24 December. Consultant cover was available on a 24:7 basis at Queen’s and from 8 am to 2 pm at King George. A national campaign – ‘Help Us Help You’ had been launched to seek to reduce pressure on A & E .

The A & E at Queen’s saw 13-15 ambulances per hour at peak times and Queen’s was now the best performing hospital in London in terms of handover time from ambulances. The planned building work would further improve this but it was accepted that it was a concern if ambulances were delayed waiting to hand over patients at A & E.

It was clarified that A & E at King George did not close after 2 am but there was no requirement for A & E consultant cover at Queen’s or King George as neither site was a major trauma centre. 24:7 consultant cover was however provided at Queen’s.

The Interim Director of Public Health explained that the flu jab was not a vaccine and the virus itself could not be caught simply from having the vaccination. Whilst flu could be caught even after taking the vaccine, it was likely to be less severe. Public Health England reviewed the effectiveness of vaccines and what strains needed to be covered each year etc. Further details about the vaccine programme could also be circulated.

The Sub-Committee noted the position.