Agenda item

10:20

To receive a joint report from Danielle Chulan, Head of Operations (South), Connect Health; Judy Foster, Senior Commissioning Manager – Planned Care (Oxfordshire), ICB; and Avril Fahey, Operations Manager, Connect Health, in respect of the performance against KPIs, successes and areas for improvement and future plans for the Oxfordshire MSK Service.

The Committee received a report by Danielle Chulan, Head of Operations, Connect Health; Judy Foster, Senior Commissioning Manager, NHS Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board; which was presented by Avril Fahey, Operations Manager, Connect Health. The report gave an overview of performance against Key Performance Indicators, successes and areas for improvement and future plans for the Oxfordshire MSK Service.

On inheritance of the service from the previous provider, Healthshare, Connect Health had received 5,414 backlog patients, 6008 transition patients, and 7,500 on the Patient Initiated Follow Up (PIFU). List. This overall added up to 19,000 patients transferred overall.

During, before and after mobilisation of the contract, Connect Health encountered a number of challenges. These challenges included the sharing of the TUPE list of clinical staff, just 10 days from the service go live date, a number of patients which had been placed on the wrong transfer list or prioritisation lists by the ongoing provider; and the early identification that there were only 2 part-time injecting clinicians for Tier 2 services, despite a significant backlog. Moreover, approximately 30% of patients which were transferred; there was a block in place which prevented the sharing of patient data. As an interim measure, Connect Health offered all affected patients an immediate telephone consultation to discuss symptoms and care. Moreover, a panel review meeting had been scheduled between the new and previous provider and the Integrated Care Board (ICB) in order to ensure this situation didn’t arise again in the future.

It was drawn out from the report that wait time for all appointments currently sat at a mean of 2.5 weeks, and a median of 1.6 weeks. The average wait for the Physioline Triage Service, currently sat at 2 working days.

Arising from Committee Members’ questions and comments the following points were noted:

·         In conjunction with the ICB, Connect Health were due to conduct a full estates and referral demand distribution review; and recognised several estate-related considerations including the long-term suitability of East Oxford for their central hub.

·         100% of backlog patients had now started their treatment; and any patients which hadn’t yet been contacted by Connect Health would have been discharged by Healthshare.

·         Between October and December 2022 there had been a significant variation in respect of experienced patient wait times. This could largely be attributed to the provider working through the inherited backlog list.

·         Although Connect Health’s contract officially started on 3 October 2022, in order to accelerate the reduction of the backlog, and with the ICB’s agreement, Connect Health started treating 1498 backlog patients prior to the go-live date via locums and available newly recruited staff.

·         Patients who were on the PIFU list were discharged after 6 months if they did not need or did not want further treatment.

·         The volume of formal complaints which had been received in respect of the service were at levels which were to be expected during the mobilisation of a new contract. 3 main themes could be drawn out from the complaints which included the symptoms of the data sharing issue between providers, the lack of clinical capacity in the south of the County and relevant patients not getting into embargoed priority and post-operative appointment slots. In response to this, following inadequate capacity left from Healthshare, there had been a concerted effort by Connect Health to recruit to its sites in the south of the county. Furthermore, it was recognised that the embargoed appointment slots had not been offered by clinicians as they should have been and training and communications to staff have since tried to the address this.

·         Members who had personal experience with the service, had found the service to be accommodating and a well communicated, smooth pathway.

·         There were concerns in respect of the service’s current ability to be accessed by those with mobility issues from the more rural areas of the county. The Committee were reassured that these issues would be factored into the wider estates review.

Moving forward Connect Health were aiming to mobilise gyms to treat patients within a wellbeing environment in order to promote lifestyle changes and to activate patients as part of their exit strategy from the service. In addition, the provider was aiming to increase its injection capacity; as well as its Advanced Practioner workforce by greater developmental pathways for Tier 1 staff.

The Chair of the Committee thanked Connect Health and the commissioner for their thorough report and attending to answer the Committee’s questions. It was agreed that subject to the Committee’s work programming process, the service should be reviewed in a year’s time and looked forward to appointing a representative to the service’s Patient and Public Engagement Group.