Agenda item

Stephen Beet (supported by Rosanna James and Alissa Davies) introduced this report setting out this programme which ensured the need for people to go to hospital was reduced and focusing on their well being and independence at home. They made the following points as part of their presentation:

·       It was important that the HWBB aligned its principles with the programme’s priorities

·       This was about an Integrated Care System approach to ensure all agencies worked together

·       The purpose of the programme was to reduce the harm to people and keep them safe

·       If people did need to go to and remain in hospital, this would ensure that they received the correct support

·       People would be supported in their communities wherever possible. Home First priorities needed to be aligned with the Locality Partnership

·       There were currently too many people in the bedded pathway when recovery in their own home was the best option. In July 2022, there had been the worst performance hospital handover times

·       If moving people back into their own home took too long, this created problems elsewhere. People awaiting treatment were in pain as they were unable to get surgical treatment. There was a target discharge rate for 70%, 38% in hospital care were currently able to be discharged but only 15% were

·       The One City Plan had a vision for strong communities. Health Watch had done work to assess the voice of people

·       The LGA supported a pier review in this area. The key focus in this area was to support people to stay well

·       Once a patient no longer needed acute care, it was important that as least time as possible was spent in a hospital bed, particularly for the frail and elderly

·       Discussions were taking place concerning how the home care provider market will work

·       Details of the longer term transformation plans were shown

·       NHS England were promoting a model to enable 100,000 people aged between 40 and 50 to be in virtual ward beds and receiving wrap around care at a distance. There was a very ambitious timeline to start this programme within the next few weeks to help avoid people deteriorating and going into long term care

·       The purpose of this programme was to develop a long term strategy to solve the problems rather than just addressing an immediate problem. Whilst some patients may prefer a warm hospital to a home which is not properly heated, there was a consensus that care needed to shift to treatment at home

·       With support from the LGA, this programme would be tested and brought back for reconsideration to the next formal meeting of the HWBB

In response to Board members’ questions, the presenters for this item  made the following points:

·       It was important to involve and support carers in the process and this would be part of the programme

·       There needed to be a strong community focus to support care not just focused on discharge points as a means to avoid problems being prevented originally

·       Developing connections was important to avoid too narrow an approach

·       The local network would be used to ensure the correct community links and engaging with the voluntary sector as required

RESOLVED that the Board –

(1)    notes and supports the immediate and short-term actions being taken to improve outcomes and flow through D2A pathways in Winter 2022/23 via the 100 day challenge and system transformation programme

(2)   supports and feeds into the development of an implementation plan for a longer-term aligned and integrated model across health and care via the LGA support offer

(3)   considers the LGA’s recommended implementation plan once their support offer has concluded with likely recommendations on models, funding and approaches to greater alignment and integration across health, social care and the VCSE sector to improve outcomes in ways that are sustainable for all partners.

ACTION: Mark Allen to add to Forward Plan for future Board meeting