Agenda item

To consider a report introduced by the Interim Executive Director of People - Adults, Dorset Council.

The Board considered a report by the Programme Director Urgent and Emergency Care, Dorset Clinical Commissioning Group which provided information regarding delayed transfers of care during the first wave of the Corona virus and information about the new Home First Programme.

The Board received a brief presentation which explained how the Home First Programme had developed from the Government's requirement in March 2020 for people's ongoing health and social care requirements to be assessed outside of hospitals through a model of discharge to assess and the move in September 2020 to a new hospital discharge operating model..  The Home First Programme was developed by the acute hospitals, local authorities and providers working together and would enable people to remain at home or return home quickly after hospital admission, support them through recovery and promote independence.

From 8 October 2020 there had been a single point of access to arrange support to enable people to return home from hospital.   Health and social care teams were now working together in five clusters across Dorset to plan a person's needs for recovery and their ongoing support.    Resources across health and social care had been pooled for greater visibility and to reduce boundaries and, in future there would be a commissioning strategy for the Home First Programme.

Members were shown breakdowns of referral and discharges numbers for September and October 2020 across community and acute hospitals for the three different pathways (returning home to a residence, moving to an interim care home placement before returning home, and a longer term placement where there had been a significant life changing event). 

The next stage would be look at helping people to remain at home and avoiding hospital admission in the first place.

The Interim Director of People - Adults, Dorset Council, highlighted the challenge across the whole system, the increasing numbers of people involved, and the hard work undertaken by teams to get people back out of the system. The new approach was a positive move towards people only entering acute care when it was necessary and were then able to return home more quickly with community support.  She highlighted the amount of pressure in the system in trying to meet people's needs.

Attention was also drawn not just to the numbers but to the increased dependency of those going into hospital and that earlier discharge meant that levels of rehabilitation and support needed in the community were higher.  It was hoped that the development of the Home First Programme would ease some of the pressures and challenges currently faced by staff.

The Healthwatch representative drew attention to a recent Healthwatch Dorset publication on people's experience on discharge from hospital.  The Chairman asked the Senior Democratic Services Officer to send this to members following the meeting.

The Board noted many lessons had been learned from the first wave of the Covid-19 pandemic, including the importance of communicating with the person in hospital and their family and friends. and supporting them to make choices about their future.  The creation of integrated teams and the single point of access meant there was less likelihood of follow ups being missed.

The Voluntary and Community Sector representative had been struck by how many references there had been to the not for profit and voluntary sector during his first meeting and was pleased with the recognition the sector had received.  The Chairman added that this sector had an increasingly important role in partnership working and that this should be recognised.

In summary, the Chairman thanked officers for their presentations, welcomed the development of the Home First Programme and recognised the pressure staff were working under.  She would talk to the Portfolio Holder for Adult Social Care and Health and the Interim Director of People - Adults to develop a narrative for sharing with Dorset Councillors to help them respond to questions from their constituents.

Decisions

1.   That the Senior Democratic Services Officer send the recent Healthwatch Dorset publication to members following the meeting.

2.   That the Chairman, the Portfolio Holder for Adult Social Care and Health and the Interim Director of People - Adults develop a narrative for sharing with Dorset Councillors to help them respond to questions from their constituents.