14.1 The Board considered a report providing an update on A&E activity across High Weald Lewes Havens Clinical Commissioning Group (HWLH CCG).
14.2 The following key points were made in response to questions from Board members:
· The CCGs plan for spikes in A&E attendance such as those that occur during winter. However, rather than commission trusts to provide larger and larger A&Es to meet increasing demand throughout the year, the CCGs are moving to commission alternative services that will help address the increasing demand for emergency care. This is the only way to make the overall healthcare service financially sustainable.
· The CCG knows from patient experience that patients using a minor injuries unit or UTC can be seen quickly and easily but when they attend A&E, due to the nature of clinical triage, they end up waiting for a considerable time. This is an avoidable outcome and one in which providing better, more easily accessible urgent care services can help overcome.
· The growth in usage of A&E is a national issue and is happening partly because of the increase in the number of patients who are frail or have co-morbidities; partly because of increased issues with access to timely GP appointments; and partly because people are well aware of its brand, know that it is open 24/7, and that it is accessible without an appointment, meaning that it is the easiest option for them to seek medical attention. Some of this demand could be addressed through the creation of UTCs in the coming months, which in some cases will be co-located at hospitals; as well as the increased availability of GP appointments through Primary Care Extended Access hubs.
· There is detailed data on A&E usage and it shows that demand is consistently high throughout the day. The type of patient attending A&E, however, changes during the week, for example there are different people attending on a Friday night compared to a Monday morning.
14.3 The Board identified the following ways in which the CCG might better communicate to the public locally commissioned urgent care services:
· Through promoting that pharmacists have the skills and knowledge to be able to treat people with minor illnesses. The message could be promoted through East Sussex County Council, Patient Participation Groups (PPGs), parish councils, local newspapers or e-bulletins, patient ‘friends of hospital’ groups, and local community transport groups. Planning for the next round of the Pharmaceutical Needs Assessment could include gaining an understanding of what pharmacies provide and what customers think of them and use them for.
· Developing UTCs as a clear alternative ‘brand’ to A&E for those needing urgent and not emergency care.
· Ensuring that Communications are not repeated too regularly or too broadly as this can cause them to fall on deaf ears. To change patterns of behaviour for service users messages should be clear, aimed at the right people, and repeated at a suitable regularity.
14.4 The Board RESOLVED to:
1) note the report; and
2) recommend that the Connecting 4 You and ESBT Alliance boards both discuss how best to promote the locally commissioned urgent care services using a consistent, appropriately targeted message.