To receive an update on the Acute Trust from CEO Neil Dardis.

Cllr Hunt highlighted that Janet King from the Frimley Health NHS Foundation Trust had given a presentation at September's Panel. Due to Covid19 the Panel had requested a further update on the Trust and Cllr Hunt was pleased to introduce Nigel Foster, the Trust’s Director of Finance, to the meeting. She thanked all NHS staff for the huge contribution they had made towards tackling the Covid19 pandemic. Nigel Foster said he hoped an ongoing relationship could be built between the Trust and the Council, after Janet King had attended the previous Panel meeting. He then gave a presentation to Members giving an update on issues affecting the Trust.

Nigel Foster said the Trust employed 10,000 people, who had been doing extraordinary things during the pandemic. Among the photos to be included in the presentation were staff from Wexham Park receiving a thank you at a Christmas angel in Slough; a bed in a refurbished staff rest area; and Di Dodsworth, the head of nursing in the intensive care team who received an MBE in the New Year’s honours. Nigel Foster said he received an email from her this week, asking to pass on thanks to a member of the IT team who had helped the intensive care team on a Saturday afternoon. He said he received an email from an ITU nurse who described her feelings of being stressed and physically and emotionally exhausted, and Nigel Foster said this reflected how a high number of staff across the Trust were feeling.

Figures included in the presentation showed the current levels of staff sickness, which accounted for six per cent of the workforce. Of those, they were divided roughly proportionally equally into those who had Covid-related sickness, those who were isolating, and those who had some other sickness. Rates had decreased, as at one point more than 1,000 staff members were off sick.

Members were told about the number of meetings taking place relating to the management structure at the Trust, and how this related to service delivery. This had been particularly important in recent weeks as the number of patients had increased. Nigel Foster explained that Covid patient numbers had been very low in August, but there had been around 700 in the last few days. This was more than double the number of patients that had been experienced during the first wave of infections, and had placed great pressures on the hospital. There had been a significant spike since December 10^th and assistance had needed to be sought from other hospitals. Some patients had needed to be transferred to other parts of the country and there had been transfers out of the ITU, both of which were unprecedented. Some facilities within the independent sector were being used to cope with the demand.

Nigel Foster said Wexham Park was one of the first sites in the country to start Covid vaccinations. As of the day before the Panel meeting, just under 14,000 vaccinations had been administered at a rate of around 500-600 per day. The majority of these were social care and care home workers, and Trust employees, although the vaccination roll-out was now being spread into the wider community.

The Panel was told the restoration and recovery programme was now being considered, as there was a significant backlog in terms of elective care. At the same time last year there were a small handful of patients who had been waiting for more than 52 weeks for their care to be completed; this figure was now more than 600. Nigel Foster acknowledged that the long-term impacts of this were still unknown, and it could take years to resolve the backlog.

Nigel Foster told the Panel that the Trust had been due to launch its future strategy on April 1^st 2020 but this had had to be postponed. The strategy’s aim was to develop the Trust over the next five years into a leader in the field of health and wellbeing and delivering exceptional services. Although it was often referred to as the Acute Trust, there was more to its scope than this, including delivering community and wellbeing services in the most appropriate way. In its six main objectives there was an aim for the Trust to be within the top ten nationally for patient safety and experience, efficiency and digital advancement, as well as being among the top ten Trusts to work for. The objectives had been developed before the first phase of Covid19 and were still considered to be the right ones to take.

Regarding Heatherwood Hospital, Members were told this was still on time and budget. Work taking place at the moment was mostly internal. Major roadworks on the main roundabout were due to start in February, and were likely to last for several months. It was hoped that the new Heatherwood Hospital would be able to accept its first patients on December 6^th. The new GP Hub built alongside the hospital was also on target for completion. A new IT system called EPIC was being installed at a cost of £100million over the next ten years, which was due to be completed by March 2022. This sought to coordinate the IT needs of all the Trust’s different teams, who were each using different systems.

The presentation also included photos of new robots that would be used during certain surgeries. Nigel Foster said the Trust was the only one in the world using the new Versius and da Vinci robots in theatres. These helped with some surgeries as they were able to make more precise incisions compared to human involvement.

Replying to questions from Cllr Hunt regarding staffing numbers, Nigel Foster said he was unsure on redundancy figures but would be surprised if there were many as the Trust was keen to retain as many staff as possible during the pandemic. There was an aversion to using agency staff as far as possible, with existing staff employed on banked shifts. However more agency staff had been brought in out of necessity during the last few weeks.

Cllr da Costa said the presentation had been informative and she was pleased to see the changes that were being made. She asked what would be done to support members of staff during the post-Covid recovery period, when their mental wellbeing was likely to be at its lowest. This was of particular concern to staff in ITU. Nigel Foster assured the Panel that arrangements were being made with two mental healthcare providers to increase the level of support, and access to those services, for staff. It remained to be seen however how many of the 10,000 staff were likely to need to use these services.

Cllr Tisi asked Nigel Foster how he thought hospitals would be assessed in future. Nigel Foster replied that there was likely to be a focus on recovery rather than meeting the backlog of targets, and a focus on treating certain demographics. He said he expected the backlog of patients waiting more than 52 weeks for the completion of their treatment would be the focus of a lot of political and media attention. There was an expectation there would be different targets and monitoring in future.

Responding to a question from Cllr Bateson, Nigel Foster said the new IT system would help eliminate a need for patients to repeat their symptoms or medical history if a follow-up appointment was made in a different hospital to the one where they had their first appointment. Different IT systems were in place in Wexham Park and Heatherwood Hospitals and there was little coordination at the moment.

Cllr Carroll asked about the ongoing plan to improve the CAMHS service and reduce waiting times. From speaking to schools and teachers, Cllr Carroll had learned there were concerns about youngsters’ ability to access services due to the Covid19 pandemic. Nigel Foster said colleagues in Berkshire Healthcare had already indicated they were concerned there would be an increase in demand for services following the pandemic, and demand was already outstripping supply. Consideration needed to be given to whether other services needed to have funding increased or decreased, and already some areas of expenditure were being postponed. Nigel Foster said increasing funding for CAMHS would help to alleviate pressure points elsewhere in the healthcare system.

Cllr Sharpe asked what the key concerns relating to healthcare in the area were likely to be over the coming months, and how long it could take the Trust to recover from the pandemic. In relation to waiting lists, Nigel Foster stated his belief this could take some years to fully resolve. He also stated his belief that funding for the NHS was lower now than it had been in the early 2000s when he had first started work for the Trust. However he felt there was now a public will to increase spending on the NHS. Nigel Foster said he was concerned that increased pressure on healthcare services would make it harder to discharge certain patients from hospital, which in turn could negatively impact on local authorities who provided services relating to providing care at home.

Cllr Hunt thanked Nigel Foster on behalf of the Panel for attending and hoped he would be able to attend another meeting in the future. She said the presentation had been very helpful and informative.