Report of the Deputy Place Based Lead, the Executive Director Adult Social Services and the Director of Public Health

This report provides an overview of the key elements of the approach to winter planning 2023/24 alongside organisational updates relating to what will be delivered by partner organisations.

The Committee considered the report of the Deputy Place Based Lead, the Executive Director Adult Social Services and the Director of Public Health that provided an overview of the key elements of the approach to winter planning 2023/24 alongside organisational updates relating to what would be delivered by partner organisations.

Key points and themes in the report included:

·         Noting that a full system winter plan would be developed through the two urgent care system boards – Manchester and Trafford Operational Delivery Group (ODG) and Urgent Care Board (UCB);

·         A first iteration of the system plan would be shared at the September Urgent Care Board, with a further update in October, and then as required throughout winter;

·         Information regarding the operational resilience across the NHS;

·         Information regarding the Urgent and Emergency Care System Plan;

·         Information regarding the Operational Pressures Escalation Levels (OPEL) Framework;

·         An update on the planned Winter Communications Plan; and

·         Organisational winter deliverables, by organisation.

Some of the key points that arose from the Committee’s discussions were:

·         Noting the pressures the NHS was already experiencing prior to additional winter pressures;

·         Noting the pressures and resulting waiting times at Accident and Emergency (A&E) departments;

·         Noting the additional impact of Covid over the winter period;

·         Advice and information needed to be cascaded to residents regarding the importance of accessing health services when they were ill; and

·         Clarification was sought on the reported need for sufficient call handling capacity within the North West Ambulance Service (NWAS) and did this indicate that it was currently under resourced.

The Group Director of Strategy, Manchester University NHS Foundation Trust stated that the report presented to Committee provided a summary of the planning work underway and advised that significant detailed work and analysis informed the planning. He commented that there were a range of initiatives to reduce pressures experienced at A&E departments, including the use of Virtual Wards that could be used to clinically care for and manage patients, and safely step up or step down care as appropriate. He stated that this could improve patient flow at A&E. He added that demand at A&E acted as a useful barometer for how the wider system was functioning. He stated that all available knowledge, intelligence and experience informed the planning for winter pressures.   

The Chief Operating Officer, Manchester Local Care Organisation advised that currently, a third of the 320 virtual community beds target to be delivered by the end of March 2024 had been achieved, adding this was in line with current projections. He commented that there was clinical evidence to demonstrate that this approach to care was appropriate for certain cohorts and conditions. He added that this approach also included participation from GPs.

The Director of Public Health responded to the comment raised regarding the need for resident advice and information. He made reference to the Winter Communications Plan that was described in the report, adding that this would be bespoke to Manchester and would include Cost of Living advice and vaccination information. He stated that information would be published in an easy to read format and available in different languages.

The Director of Public Health advised the Committee that following publication of the report the date for care home residents and staff for flu and Covid vaccinations had been brought forward from October to commence the 11 September and the 18 September for all other eligible cohorts. He added that this decision had been taken in response to the new variant of concern that had been identified, variant BA.2.86, also known as Pirola. He advised that all existing trusted networks would be used to articulate and promote vaccination information and advice.

In response to the discussion regarding call handler capacity within NWAS, the Deputy Place-based Lead, NHS GM (Manchester) advised that the reference in the report referred to the need to ensure that capacity within this service was adequate to respond to the winter pressures.

The Executive Member for Healthy Manchester and Adult Social Care commented that there was an established and strong dialogue across all health and social care partners in the city to enable the planning for winter. He advised that the Winter Plan would be reviewed monthly by the Manchester Partnership Board and all Councillors would be kept updated by himself. He noted that the Committee would be considering a report at the February 2024 meeting that reflected on how effective the winter planning had been.

Decision

To note the report.