Agenda item

To consider a report by the Interim Executive Director for People - Adults.

The Committee considered a report by the Acting Executive Director People - Adults which provided an overview of the progress made to date with Delayed Transfers of Care (DTC) and continuing areas for improvement.

The Chairman apologised for the report being written from Dorset Council's point of view as neither Dorset County Hospital NHS Foundation Trust nor the Dorset Clinical Commissioning Group had been given the opportunity to contribute.

Members noted that there had been a significant reduction in DTCs for Dorset residents and that the overall trend was downward.  However, even though Dorset's performance had improved, so had other local authorities, and Dorset remained in the bottom quartile.

The report gave details of performance against the Better Care Fund (BCF), Dorset Integrated Care System delays, causes of delays, Integrated Care system improvements and opportunities for further improvement. 

The main cause of delay was waiting for care packages to be arranged for people in their own homes, particularly if they lived in rural locations.  One of the measures to reduce delays was to plan patient discharge from the time they entered hospital, giving them choice where possible.  Some of this had been achieved through the realignment of existing resources with the Better Care Fund (BCF) being used to enhance the support people were offered. 

Members thought it would be helpful to see how Dorset compared with other rural local authorities and what they were doing to be in a better position than Dorset in order to improve Dorset's position. Officers explained that any improvement would be based on developing locality and community groups who could respond to people's needs and support them at home and a move towards a discharge to assess model of working in hospitals.

Whilst members recognised the improvements made, they highlighted the need for improvement in the provision of care packages at home and asked what measures were being taken to address this. Officers explained that a fundamental rethink of the home care market was needed given the difficulties of providing care in rural areas, the distances care workers traveled and the time involved.  A more outcome-based approach was needed and care providers were being asked to work with individuals to meet their needs. There was also a need to make care a viable work option for people, including young people, to develop community resources, and provide affordable and key worker housing.

Somerset seemed to have solved DTCs and their performance had dramatically improved but there was no information as to how this had been achieved.  Members noted that officers were currently working on a "dashboard" and asked that this be produced on a six-monthly basis. 

It was suggested that as Dorset had one of the oldest populations, a question for the 16 June meeting when representatives from Dorset County Hospital and the Clinical Commissioning Group would be present, would be whether too many hospital beds had been cut and whether the trend for more people to live to be over a hundred had reduced over the last ten years as a result.

Members highlighted the following issues which could be addressed at the Inquiry Day to be rescheduled for April 2020:-

care market implications, future projections, changes to be achieved next year, the five-year plan, outputs for inputs shown, costs versus each of the activities, and recruitment and retention of staff. 

A concern was expressed that under the new governance arrangements the Inquiry Day might not proceed.

Noted