Public Board of Directors papers 241122

Greater Manchester System The Greater Manchester health and social care system remains under immense operational pressure at all levels. This is shown through high numbers of patients waiting in A+E departments, long ambulance hand over times (average 49 minutes), high bed occupancy rates (94%), and high numbers of people awaiting discharge from hospital but unable to return home or to social care facilities (906). Elective care backlogs remain with 24 patients having waited over 104 weeks. For cancer care levels of referrals and diagnostic assessments have returned to or exceed pre pandemic levels (Two week wait referrals are now 115% of pre-pandemic levels) but treatment capacity (predominantly surgical) remains under pressure. The number of patients that have waited over 62 days is 3083 774 have waited over 104 days. Pressures from urgent care has led to some cancer operations at other hospitals being cancelled. We continue to offer the opportunity for hospitals across Greater Manchester to use facilities at The Christie where this enables patients to be treated within acceptable timescales. Responsible Director – Director of Strategy, with Chief Operating Officer for system performance issues and Deputy CEO for strategic issues. The CEO is the chair of the Greater Manchester Cancer Alliance Board. Responsible Assurance Committee - Board Regulatory Landscape The UK Covid-19 Inquiry opened its third investigation, which considers the impact of the Covid-19 pandemic on healthcare in England, Wales, Scotland and Northern Ireland on 8 th November. The Inquiry will investigate and analyse the healthcare decisions made during the pandemic, the reasons for them and their impact, so that lessons can be learned and recommendations made for the future. Module 3 will examine the consequences for healthcare of the response to the pandemic. It will look at how the healthcare systems responded, the impact on systems and services, including on patients, doctors, nurses and other healthcare staff. The Inquiry has set out 12 key areas for investigation in its scope, including: • core decision-making and leadership; • staffing levels and critical care capacity (including the establishment and use of Nightingale hospitals); • the prevention of the spread of Covid-19 within healthcare settings (including infection control and the adequacy of PPE); • communication with patients with Covid-19 and their loved ones about treatment – including discussions about Do not attempt cardiopulmonary resuscitation (DNACPRs); • shielding and its impact on the clinically vulnerable; • the long-term effects of Covid-19, including Long Covid. NHS England (NHSE) has published three sets of documents: 1) Its consultation on changes to the NHS provider licence. The consultation runs from 28 th October for six weeks, closing on 9 th December 2022 The new licence now covers NHS Trusts as well as Foundation Trusts and the consultation proposes four types of changes to the licence aimed at: 1. Supporting effective system working 2. Enhancing the oversight of key services provided by the independent sector 3. Addressing climate change 4. Technical amendments 2) A new code of governance for trusts, and related documents The new code will replace the NHS Foundation trust code of governance, which was last updated in 2014. For the first time, the code will apply to all trusts.

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