Agenda item

To receive an update on the Integrated Care Alliance Work Programme.

The Board received an update from Emma Higgins (Associate Director – Wiltshire ICA Programme and Delivery Lead). The item covered the following matters:

• An update was provided in relation to the Wiltshire ICA, with it noted that a Partnership Committee had been established with two meetings having taken place. Over the coming months the Alliance priorities and work programme would be refreshed and that there was set to be a committee meeting in January.
• The interim delivery areas for 2022-2023 were outlined.
• The ICA work programme for 2022/2023 was outlined with specific reference given to the Alliance Neighbourhood Collaboratives programme and the Connecting with Our Communities programme. Progress updates were provided for both programmes as well as the expected and desired outcomes.
• The principles for the ICA refreshed transformation plan were outlined, which had arisen through development work which had taken place.

Comments were received in relation to the following points:

·         It was suggested that hospital flow had had now been a problem for 2 years, with 57 people currently stuck in the RUH A and E department, though they are fit to go home. It was questioned whether it was known what was stopping each patient from leaving, to which it was clarified that it was pathways of care that was preventing discharge, though the condition of each individual patient was known.

·         It was suggested that the ICS is well sighted of the immediate crisis and that there were other various forums across the ICB where urgent emergency care was being addressed. Additionally, a half-day workshop was set to take place for the Health Select Committee, where scrutiny would be applied to look at the whole system issue.

·         It was suggested that though it is known what pathway of care a patient is on, it can be complex regarding why a patient is or is not ready to be despatched. Additionally, the government is helping to maximise capacity to gain a stronger understanding of the issue.

·         Innovative work is being conducted from BSW in coordination with SWAST, Acute Care providers and community care to look at ambulance calls to determine those who need an ambulance and those who could be dealt with differently using a range of options available.

·         An accommodation centre has recently started in the Great Western Hospital, which has consequently seen less use of ambulances as well as the use of care coordinators to provide prevention and intervention.

·         It was stated that the ICA had been conducting a Discharge Communications Project to discuss discharge with populations and how best individuals can remain out of hospital.

·         The importance of educating people to call GPs rather than 111 was stated as well as the use of technology. Additionally, hospital discharge can sometimes be delayed by the provision of data from the hospital to the ward.

·         It was stated that currently the ICB has a chronic state of escalation and that this has consequently caused problems. It was acknowledged that prevention and early intervention offer long term opportunities for the population as well as being financially sustainable.

Decision – The Wiltshire Health and Wellbeing Board accepted the following recommended proposals:

i)                The Wiltshire Health and Wellbeing Board noted the update provided.