Agenda item

David Latham – programme Manager for Urgent Care, NHS GM (Bury) and Kath Wynne-Jones – Chief Officer, Bury integrated delivery board to present this item

The Chair invited David Latham, Programme Manager for Urgent Care at NHS GM (Bury), and Kath Wynne-Jones, Chief Officer of the Bury Integrated Delivery Board, to provide an update on the operation of the urgent care system and winter planning preparations.

Kath Wynne-Jones began by offering a strategic overview of the Hospital at Home services and the Live Well programme. She emphasized the importance of integrating neighbourhood teams and refreshing the approach to multi-disciplinary working. The presentation slides outlined the integrated delivery programme, which aims to standardize health services and foster collaboration between neighbourhood and healthcare teams. Kath highlighted the positive outcomes achieved in terms of admission avoidance and managing patient volumes. She confirmed that the refreshed neighbourhood model would be brought to the committee in the coming months to provide further context for winter planning over the next 18 months.

David Latham followed with a performance update, focusing on urgent care metrics. He reported improvements in the four-hour A&E target, with Bury achieving 74% in July and 72% in August, and Fairfield Hospital reaching between 73.3% and 75%, making it the second-best performer in Greater Manchester. He also noted a significant reduction in 12-hour waits, with figures dropping from 341 in July to 314 in August, well below the national ceiling of 577 patients. Ambulance handover times were another area of success, with Bury achieving an average of 16 minutes and 28 seconds, surpassing both the national target of 35 minutes and the GM stretch target of 25 minutes and 24 seconds.

David acknowledged a slight increase in patients staying in hospital for more than 21 days in August and mentioned ongoing efforts to understand and address this issue. He also discussed the Days Kept Away from Home (DKAH) metric, noting that while targets are not yet met, improvements are being made. Unplanned hospital admissions for patients over 65 were reported to be better than most areas in Greater Manchester, with some pockets of improvement still needed.

Regarding winter planning, David described a regional event held to discuss transfers and escalation procedures, with a Bury team scheduled to attend a major event on October 3rd. He confirmed that the Northern Care Alliance (NCA) had submitted its winter plan, incorporating local input. Daily escalation and planning meetings are now in place, and a Winter Planning Subgroup has been established to coordinate efforts across local partners. This subgroup is responsible for refreshing OPAL cards, setting escalation triggers, and providing training for on-call managers. Plans for respiratory hubs and vaccination targets were also outlined.

During the discussion, several councillors raised questions and comments. Councillor McBriar expressed concern about the impact of anti-vaccination sentiment. Jon Hobday from Public Health responded by explaining the multifaceted reasons behind low vaccination uptake, including misinformation and access issues. He emphasized ongoing work with primary care to address inequalities and the importance of councillors advocating for vaccinations.

Councillor Duncalfe inquired about COVID-specific planning. Jon Hobday assured that symptom awareness and self-care are being promoted, with clinical discretion guiding treatment approaches. Councillor Haroon questioned missed targets, to which Adrian Crook responded by highlighting Bury’s strong performance relative to national benchmarks and the challenges posed by ambitious targets and data collection issues.

Councillor Tariq emphasized the broader system pressures, including mental health and workforce challenges, and stressed the importance of integrated working across NHS, social care, and the voluntary sector. Councillor Boles asked about financial implications, and Will Blandamer reassured that core schemes are funded and discharge capacity is protected.

Councillors FitzGerald and Frith discussed public perception and data visibility. Adrian Crook confirmed that performance data is shared with the Department of Health and Social Care and may prompt a ministerial visit. Councillor Quinn raised concerns about low vaccination uptake among vulnerable groups, and Jon Hobday confirmed ongoing monitoring and engagement efforts.

It was agreed:

·       To bring back to the committee around vaccination programmes,

·       Materials on vaccination hesitancy to be circulated to members.