To receive information on the:

·         Winter Preparedness Plan

·         Sunningdale Health Hub

·         Walk in urgent care services in Maidenhead, Windsor and Ascot

Reporting officers:

Alexandra Tilley - Director of Operations - RBWM / Primary Care Transformation

Stephen Dunn - Director of System Delivery & Flow and Royal Borough of Windsor and Maidenhead

Stephen Dunn said that work had been done by NHS Frimley on the urgent and emergency care service plan, against high financial pressures. Demand had continued to increase, particularly with recent disruption from strike action and financial challenges. There had been an additional 50 patients per day at Frimley Park compared to this time last year. The strategy was moving forward and considering winter priorities.

The urgent emergency care transformation plan had been developed in spring, at the start of the financial year. A letter from NHS England set out the requirements for this forthcoming winter and what was needed to prepare. The letter contained lots of guidance and responsibilities and was publicly available. There were four main areas of focus:

• Continue to deliver UEC recovery plan by ensuring high impact intervention were in place.
• Completing operational and surge planning to prepare for winter scenarios.
• ICBs should ensure effective system working across all parts of the system.
• Supporting our workforce to deliver over winter.

Stephen Dunn outlined in detail some of the targets of NHS Frimley with regards to the Intermediate Care Response, primary care, community services, children and young people, and communications and engagement.

Kevin McDaniel, Executive Director of Adult Services and Health at RBWM, and Lin Ferguson, Executive Director of Children’s Services and Education at RBWM, joined the meeting.

Stephen Dunn updated the Board on the Sunningdale Health Hub. NHS Frimley continued to be committed to the project and the building was planned to meet both current and future needs. There had been one technicality which had been worked through with the landowners and full planning permission had been received in September, NHS Frimley had three years to build the health hub. Commercial negotiations were ongoing and the team were waiting for funding to be unlocked. The Sunningdale Health Hub was planned to be open in either 2025 or 2026.

Councillor Werner commented that it was good news that the project was still going ahead. He asked if there were any barriers or hold ups from the council, and if so what he could do to remove them.

Stephen Dunn confirmed that there were no barriers from the local authority which he was aware of, he said that there had been great support from colleagues at RBWM. The team were doing everything they could to keep moving the project forward.

Stephen Dunn moved on to discussing walk in services across the borough. NHS Frimley was working through winter plans and looking at models to target inequalities and the anticipated high usage of A&E. St Marks was important to the local community, the urgent primary care service had capacity for minor injury and minor illness appointments. NHS Frimley would be continuously evaluating the impact on the service and that it met the needs of local people. The team had done a leaflet drop earlier in the year to show how primary care was changing. The new service offered longer opening times than before and a wide range of staff were available. There were around 600 appointments available each week, this was double what the walk in model had. Usage of the walk in model was only around 50%. St Marks was at 85% capacity for minor illness service and minor injuries was at 97% usage. The appointment system meant that people were treated quickly. An improved telephony system had been installed at all Maidenhead practices which had improved patient access.

Huw Thomas added that St Marks access needed to be taken in context across the whole system. Same day appointments were the highest level in the region and there was therefore huge demand on primary and secondary care.

The Chair asked what the typical waiting time was after a resident had contacted St Marks by phone.

Stephen Dunn said that the phone wait time was around three or four minutes. Approximately 60% of residents gained an appointment on the same day that they called and this was reflected across Frimley. Stephen Dunn explained that access and transformations had improved primary care which many people did not realise.

Councillor Taylor asked if the GP hub at St Marks would be continuing to provide ‘out of hours’ appointments.

Huw Thomas confirmed that the GP hub had never been closed and was continuing on the same hours as it was before.

Councillor Taylor said that she had recently been using her GP more often and felt that communication had improved and making changes to appointments was now very easy. She expressed concern that the walk in unit was not being implemented at St Marks. Councillor Taylor said that if she had a medical issue, she phoned 111 first and if she needed to be seen in person it was usually either Wexham Park or Reading. Many residents were not aware of the 111 system or other ways to get help. Councillor Taylor asked if this would be changed and if there were any financial or staffing limitations.

Stephen Dunn responded by saying that the appointment model had doubled capacity and improved utilisation. The walk in facility had not been used to its full capacity which is why the model of delivery had been changed. Clear communication about the changes at St Marks had been given to residents.

ACTION – Stephen Dunn to explore how communication on the model of delivery at St Marks could be further implemented and whether there were any opportunities to do this through RBWM channels.

Councillor Werner felt that the new system was positive and had been pleased to see issues around telephony had improved. He said that the walk in model was still an important method of delivery as NHS Frimley had been introducing them in other areas, for example Slough. Councillor Werner therefore asked why it was believed this system was not right for Maidenhead.

Stephen Dunn said that the team were working through options for this winter and they would communicate on the models of delivery as soon as they had been confirmed. The Slough population were heavy users of Wexham Park Hospital and the walk in services would make a big difference to the local population.

Councillor Werner suggested that he would discuss this point further with Stephen Dunn outside of the meeting. He commented that Maidenhead had serious pockets of deprivation but the NHS did not target these areas with the same level of resource as it did with Slough.

Joanna Dixon noted that a couple of communication campaigns had been mentioned, around primary care delivery and the transformation of primary care. She asked if they would come out from Frimley ICB or if they were still in development.

Stephen Dunn confirmed that these campaigns were still in development but would be shared extensively once they were ready.