Report attached.

Officers advised that Covid-19 had affected of course services provided by the Trust. In mid-March BHRUT was faced with challenges of how to keep patient and staff safe physically and mentally as the focus turned to providing support for Covid. The Trust had suspended all but the most important services in its hospitals and quickly moved the most vulnerable e.g. trauma care and cancer patients to the independent sector which had  worked well.

Virtual clinics worked well as the Trust converted thousands of face-to-face appointments to virtual meetings. Re-deployment and re-training of staff had taken place to respond to Covid demands on the service.

Most services that were previously pulled back due to Covid had been configured differently in a phased way in line with the national Infection Prevention and Control (IPC) guidance.

Due to the increased prevalence of Covid within the community the Trust was are building on the lessons learned and how it managed Covid alongside keeping other services running, managing and balancing this across the two hospitals. Covid had however impacted all types of performance.

Emergency Department performance had dropped to 63.44% and although the Trust had less attendances it had to segregate services and at one point had 25% staff sickness.

Attendances were now starting to increase for complex patients and added to this has been the capacity reduced since Covid in hospitals due to social distancing measures. Other measures to get back on track include same day care improvements, frailty unit set up at King George’s Hospital now being back open and a whole hospital improvement plan.

The Trust’s validated cancer performance had improved slightly in August and was expected to improve further in September.

Waiting lists had grown and BHRUT was working with partners to make sure it was using all capacity available. The national expectation for outpatient activity was to be back on track for 70% outpatient activity in September.

Insourcing was being used to manage the problems with 52 week waits. Cancer services would continue to be managed through the independent sector  Current challenges included the capacity for swabbing and testing.

Q1 - Cllr Ciaran White: What is the strategy to keep A&E walk-ins low.

Answer: The strategy is ‘talk before you walk’ i.e. to contact NHS 111 first. This had reduced the numbers of walk in patients at A & E.

Q2 - Cllr Ciaran White: Can you explain the extra funding for A&E over the winter period?

Answer: NHS has been asked to bid for money (mostly capital); BHRUThas put in separate bids for the two hospitals and hae been given £4-5 million for Queens Hospital.

Q3 - Cllr Nic Dodin: What is the position with  the funding obtained for a new RAFTING System at King George Hospital?

Answer: The Rapid Assessment and Fast Treatment Area (RAFT) is in Queens however, this is not currently in place at King George. In terms of the activity the Trust did not currently  compare this like for like across the two hospitals  but would bebe starting to do so from the 15^th September.

Q4 – David Durant: What is the distinction between Covid cases and mortality? is there a big distinction?

Answer: Testing was key to this but the Trust would supply a response via the medical director.

Q5 – David Durant: If we are relying on the vaccine – what is the effectiveness of the flu vaccine?

Answer: The Council’s , Director of Public Health confirmed that there was very strong evidence that the vaccine reduced the most serious consequences of the flu, therefore it would reduce the number of people being admitted to hospital and potentially dying of the flu. It did not however stop the spread of influenza itself.

The Sub-Committee noted the position.