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Statement by the President, Committee for Health & Social Care

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Wednesday 16 June 2021

General Update

Thank you sir,

Since my last Statement in December, a lot has happened. We've had a second lockdown bringing with it a requirement for health and social care services to once again work differently to ensure the continuation their vital work. We continue to deliver the largest-ever vaccination programme with over 75,000 doses administered and since the testing programme began last spring, our pathology teams have now processed over 112,000 tests.

In a HSC context, exiting lockdown is as challenging as lockdown itself and teams across HSC have been working hard to both manage increased demand and maximise activity to support as many islanders as possible in getting the health and care services that they need. This does mean that HSC is exceptionally busy and this level of demand is likely to be the 'new normal' for some time. It is challenging, and while on a small number of occasions, difficult decisions may need to be made to postpone elective surgery, capacity continues to be there for those who really need our care. However we have a finite number of beds, and we need to use these to best effect which is why HSC staff continue to work with patients' families and the care home sector to facilitate appropriate discharge planning. Realising the ambitions of SLAWS agreed by the Assembly last August will also be key to ensuring that as a community we have a sustainable plan for providing individuals with the right care, at the right time, in the right place, be that in hospital, in a care home or in someone's own home. Within the hospital, bed occupancy is reviewed constantly and we've been working with our Medical Director and other senior colleagues to understand how we can support our teams by concentrating resources to help address the backlogs which have arisen during the pandemic in some specialisms. We know that islanders waiting for orthopaedic surgery make up the large percentage of those waiting for operations and we're working to understand how we can maximise our existing infrastructure to increase on-island capacity.

But there is no overnight fix and our hospital modernisation is key to ensure that we have the capacity needed to meet demand as it continues to rise. Subject to continued support, we remain on track to start the building work for Phase 1 - which includes an upgraded, more flexible Critical Care Unit and refurbished post surgery care unit - by the end of this year. Providing this increased capacity will not only improve the care that we are able to provide on-island, it will save money by avoiding expensive off-island care. And while we're grateful for the continued support provided by our UK partners in providing tertiary care, we know that commissioning routine work off-island will undoubtedly be difficult for a long time to come.

I was pleased that so many States' members took opportunity last week to have a tour of our hospital to understand how all three Phases, if supported, will provide us with the flexibility needed into the future so to improve care, efficiency and ultimately reduce length of stay in hospital.

Positive progress has been made with our e-Heath record project and we have appointed a preferred partner to progress the replacement of our electronic patient record. It is anticipated the implementation will start in the late summer and will involve all of our staff and services.

We are looking forward to debate on the Government Work Plan next month and the opportunity to create an environment for health, supporting all islanders to live healthier lives. Evidence from around the world shows that health is a good measure of social and economic progress. And this isn't just a question of how well health services are funded and how they well function, important as that is and will continue to be, but the wider circumstances of how people live, work, and age; the social determinants of health which through the Government Work Plan we are all able to address. This will mean grappling with some challenging issues, including how to ensure that all children have the best possible start in life, how to make primary care more affordable and how to best support health and wellbeing in schools and workplaces.

This is all reliant on cross-Committee working and we have met with the Committee for Home Affairs to discuss closer working and have a further meeting scheduled for next month where we hope, subject to prioritisation in the Government Work Plan, to progress the review of alternative and non-punitive approaches to the possession and use of small quantities of illegal drugs and other matters of mutual interest. We've recently met with the Committee for Employment & Social Security and agreed to set up a working group, in conjunction with our partners in primary care, to review the model and funding of primary care in the island. The first step towards this is the introduction of low cost appointments for children funded through the reallocation of family allowance which Deputy Roffey spoke about in his update. Positive discussions are underway with GPs and dental practices ahead of implementation in January 2022.

We are also taking opportunity to consider mental health and wellbeing recognising that it's an area that understandably attracts considerable public interest. We want to ensure that the gaps identified in the last term in the community space are addressed as a priority through a Crisis Centre pilot and that steps are taken to understand the experiences of service users and providers so that we can ensure that resources are directed where they will have the greatest effect.

The core focus for our specialist teams in secondary mental health is mental illness. Figures over the first five months of 2021 show on average 150 referrals per month across our six main mental health service areas. On average, the Duty and Intervention team receives the greatest number of referrals and these are triaged based on the information provided by the GP. Primary care, in their referral, may be seeking advice/guidance on treatment options and therefore an individual will in this case, remain under the care of their GP.

Psychological Therapies are the only area within HSC with a waiting list for specialist interventions which is now seeing a downward trend since staffing levels have improved within the department.

We have met with the Health Improvement Commission and are looking forward to the formal launch, in conjunction with the Guernsey Community Foundation, of Bailiwick Social Prescribing in the next few weeks. We'll shortly be publishing the Combined Substance Use Strategy which informs much of the Health Improvement Commission's work.

We have met with Health Connectionsto discuss their valued work in the Bailiwick. We're pleased to be able to accommodate Les Bourgs Hospice while building work is undertaken at the Hospice and are committed to working with all our private and third sector partners.

We are looking forward to visiting Alderney shortly. We know there are considerable challenges delivering and funding services on such a small Island, and with ageing demographics the challenges are not going to get easier and it is fundamental we work with Alderney to mitigate this and work to solutions to ensure the services are sustainable and as safe as possible.

Sir, it is difficult in just 10 minutes to do justice to a mandate as broad and as complex as HSC. I am happy to answer, or take away, questions. 

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