Redbridge CCG reply to Questions

Thank you to Redbridge Clinical Commissioning Group for providing the below

Oral questions from Cllr Andy Walker


Q: The CCG will be asked to seek an explanation from BHRUT as to why bed occupancy at Queens is 94% and 79% at KGH as CQC recommend a safe level of 85%.
A: In terms of high bed occupancy at Queen's, it's simple - too many people are being admitted to the hospital and those that are in there stay too long.
We launched two new services to Redbridge in November that are already having an impact on this - the Community Treatment Team and Intensive Rehab service - which help prevent admissions and also help get people home sooner. At the moment the CTT team at the hospital is able to treat and prevent around 60 people a week from being admitted. CTT teams in the community are currently treating and preventing more than 130 people a week from ending up in hospital. We've also reduced the time it takes to move people from a hospital to a community bed from 5 to 2 days.
The CCG and our health and social care partners are working in partnership to improve the integration of care so that people spend less time in hospital. The Trust is starting seven day working and a new joint discharge team will launch soon. Our draft 5 year strategic plan, which goes to NHSE in April, includes an objective to reduce avoidable time in hospital through integrating care by 13%.

The work we are doing on this with our health and social care partners has seen a reduction in admissions of 15% in the past 12 months and a reduction in A&E attendances of 5.67%.

Q: BHRUT is unable to provide waiting list figures for technical reasons and the CCG will be asked about this too.

A: This is caused by problems associated with the Trust's change of IT patient administration
system which means the Trust doesn't have access to accurate data and therefore isn't able to report waiting times at the moment.

This is a serious issue and the trust is working with the Trust Development Authority and our CCGs to help establish an interim solution while the IT issues are resolved.



Q: Cllr Walker will also call on the CCG to 'scrap the plan to close A&E at KGH in 2015'.

A: The plans to reconfigure services were signed off by the secretary of state for health in 2011, following a lengthy public consultation and an independent review by a panel of experts. Our job is to work with the hospitals Trust and other partners to implement those proposals safely and improve health outcomes for local people.

Centralising A&E services on one site will enable BHRUT to provide a safe, high quality A&E service. At the moment the service is stretched across two sites and the CQC identified that at times it may be unsafe because of this (e.g. staffing issues). We can't leave things as they are - it's not an option.

That's why we are looking at improving the entire urgent care pathway so that patients can be seen in the right place, more quickly, by the right teams with the right expertise and leading to better outcomes and shorter waiting times. Most people who go to KGH A&E now will still be seen there by an improved 24/7 Urgent Care Centre.

Last year we centralised maternity services and it has given us a safer, higher quality service for Redbridge women. That's what we plan for A&E.



Oral question from Cllr McGeary


Q: The improvements required by the Health for NEL proposals to A & E are likely to cost £50 million through the PFI route and are, as the trust says, unaffordable. How can the BHRUT say that they will still close King George A & E by December 2015 and still comply with the Secretary of State's statement that the reconfiguration changes will not happen until the health for NEL improvements have been made.

A: We've been very clear all along that changes to A&E services - just like maternity last year - cannot happen until it is safe to do so. That won't change. One result of the Trust being placed in special measures is that the new leadership is producing an Improvement Plan that will not only demonstrate how they will make the very necessary improvements to safety and quality of services, but will also show how they align this with the reconfiguration proposals.

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