The Sub-Committee is provided with an update on the performance of urgent and emergency care at Croydon University Hospital with a view to informing a discussion on the information contained.
The Committee considered a report which provided an overview on the current performance of the urgent and emergency care department at Croydon University Hospital. The report was introduced by the Chief Operating Officer for Croydon Health Services NHS Trust (CHS), Lee McPhail. During the introduction the following was noted.
Following up from the introduction the Sub-Committee questioned how whether the capacity target was achievable. It was acknowledged that this would be a challenge for most hospitals, with Croydon University Hospital’s own capacity often nearer to 98%.
Regarding the performance data provided on London Ambulance Service handover times of over 30 minutes, which were currently above 20%, it was questioned whether the 5% target was achievable. It was advised that for the majority of the past year the figures were closer to the 5% target with the performance at Croydon University Hospital one of the most improved in London. However during the winter period there had been issues with congestion in the emergency unit and also spikes in attendance that had increased handover times.
A key area of focus was the whole pathway through the healthcare system as a means of alleviating pressure on urgent and emergency care. For instance the uptake of GPs appointments available on Sundays had increased from 20% to approximately 60%. Other initiatives such as having paramedics working in the emergency department were being trialled, with the possibility of having physio therapists available as well being explored.
The Sub-Committee noted from the information provided that there seemed to be a constant level of pressure on services throughout the year, with it confirmed that this was the case, although the acuity profile of patients changed throughout the year with sicker patients in the winter bringing different pressures.
Although the number of seasonal flu case had been lower, it had still been challenging as these patients tended to slow the emergency pathway due to the need to mitigate against the risk of infection. The use of rapid screening had improved over the past year, with the best course of action being to treat the patient at the hospital and for them to recover at home.
In response to a question about hospital staff taking up the flu vaccination, it was confirmed that the current rate was 79% against an 80% target. The number of staff having the vaccination earlier in the flu season had increased this year which helped to make a difference. The ongoing work to encourage people to take up the flu vaccination was welcomed by the Sub-Committee, particularly as statistics showed that 26,000 people died from the virus last year.
It was highlighted that anecdotally there seemed to have been a number of instances where patients had their regular appointments cancelled and it was questioned whether this had been planned to increase capacity at the hospital. It was confirmed that there was not a policy in place at the moment, however this could change should there be a need to create additional capacity to deal with emergency pressures.
In summarising the item, the Chair acknowledged that the improvement work being delivered at the hospital was reassuring, but felt that the new clinical guidance would provide additional challenges. It was recognised that the ongoing integration programme would also lead to improvements and as such it would be important to revisit the performance of urgent and emergency care at Croydon University Hospital later in the year.
At the conclusion of the item the Chair thanked the officers for their attendance at the meeting.
Following discussion of the report, the Sub-Committee reached the following conclusions:-