Agenda item

To consider a report by the Programme Director Urgent & Emergency Care, Dorset Clinical Commissioning Group.

The Committee considered a report by the Programme Director Urgent and Emergency Care, Dorset Clinical Commissioning Group which set out performance information regarding length of hospital stays during the first wave of Covid-19 and the new Home First Programme.

Members noted that performance information for delayed discharges of care had not been collected during the first wave of Covid-19 and that information regarding length of stays had been captured instead.  In June/July 2020 there had been a review across health and social care and a move was made to a Homes First model.  Its purpose was to enable people to achieve independent living within their community, to speed up discharges from hospital and to prevent unnecessary hospital admissions.  A further set of guidance was issued for implementation of a hospital discharge service beginning from 1 September 2020 and this was model was complemented the home first programme.

A multi-agency approach was now taken so that people were assessed by health and social care teams at home for the ongoing support they needed.  There were now five cluster teams for Bournemouth and Christchurch, Poole, East Dorset and Purbeck, North and Mid-Dorset and West Dorset and Weymouth.   They comprised acute hospital staff and community social care staff working together to undertake assessments in people's homes in order to support their needs and prevent unnecessary hospital admissions.

One member welcomed the new programme but asked whether the same number of people were being discharged from hospital or more and referred to the previous frustration of trying to arrange care packages and asked whether patients were being discharged without care packages in place.  It was explained that the single point of access meant that the patient returned home safely with the support they needed.  There were then ongoing social care reviews within the community to ensure that the right support was provided as their needs changed.  Over time the new programme would provide a more consistent, less fragmented approach, would provide a better experience for residents and enable the community and voluntary sector to support the programme.

With reference to Tables 1 and 2 on page 13 of the report, a member asked whether this was a snapshot on a particular day or whether figures were for the whole month, and whether some patients might be double counted if they had been in hospital for a long time.  As the report author had not been able to join the meeting, a broad overview was given.  Members asked that this information be circulated following the meeting so that they could better understand the information presented.

Members welcomed the new Programme but highlighted the need for funding and staffing if the system was to work well.  Officers explained that they could only work with the resources available.  It was hoped that by being more efficient, reducing duplication and working together resources could be maximised.  If any gaps were identified, commissioners would be approached to address these.  The aim was for residents to gain greater independence and reduce pressure on local health and social care resources.  As the programme was still new, there was little data available to show lengths of hospital stay and gaps etc.  This information would become more visible over the next 3-6 months.  The Acting Corporate Director of Commissioning added that the Committee had the opportunity to scrutinise previous performance of delayed discharges and compare it with the new Home First Programme. 

The Chairman asked for an update to be provided in six months' time and for this to include information about staff capacity, support from and for communities and families and performance metrics.

Decisions

1.   That the Committee welcomed the Home First project and appreciated the current difficulties.

2.   That an update to be added to the Forward Plan and which would include staff capacity, support from and for communities and families and performance metrics.

3.   That further information on tables 1 and 2, page 13 of the report be provided as set out above.