Agenda item

(To receive a report by Tracy Perrett, County Manager – Hospitals and Special Projects, which provides a summary to members on Winter Funding for Adult Social Care Services to alleviate winter pressures on the NHS)

Consideration was given to a report which provided a summary to Members on Winter Funding for Adult Social Care Services, supporting an aim to alleviate winter pressures on the NHS.  It was reported that in October 2018 the Secretary of State for Health and Social Care had announced £240m of additional funding for council's in England to spend on Adult Social Care Services, and this had been divided between the local authority, with Lincolnshire County Council receiving £3,367,950.

The key areas that Lincolnshire County Council focused on fell broadly into the categories of supporting hospital discharge with a focus on flow through the hospitals, and admissions avoidance.  Members were guided through the various schemes which were set out in the report and provided with the opportunity to ask questions to the officers present and some of the points raised during discussion included the following:

·         Lincolnshire as a system had improved its performance, whilst many other areas had not improved.  For example, in Lincolnshire Delayed Transfers of Care (DTOC) had reduced from 3.5% to 2.6%.

·         In relation to the housing link worker, it was noted that they would be based at Lincoln County Hospital as that was where the greatest demand would be, but they would cover all the other hospitals as well.

·         It was acknowledged that extending the delivery of equipment from five to seven days a week had not been as successful as hoped and a number of barriers had been identified.  However, it was queried whether this was a level of service which was required as in many cases equipment needs could be planned in advance.  It was more an issue of culture and how colleagues could be supported with discharge planning.  It was suggested that this should be a process which should be started as soon as an individual enters hospital.

·         It was noted that Lincolnshire County Council staff were 'ward aligned', which meant they should be informed when a patient was admitted.

·         Members praised the work which had been done so far. 

·         Concerns were raised regarding cross border working, as in the north of the county people were more likely to be taken to an out of county hospital (Grimsby, Hull or Scunthorpe).  Members were advised that work was underway to look in more detail at cross border working, and that the location of GP practices played a role in this, as the County Council and NHS boundaries did not directly match up.  There was a possibility that the proposed primary care networks might assist in this.  If services were devolved to place and locality and there were place based budgets, this may start to resolve some of the issues.

·         It was highlighted that some of the work being carried out by the Local Enterprise Partnership (LEP) should help with improving cross border working.

·         It was commented that the advance announcement of funding had been positive, and that as a result planning and performance had been improved.

·         There was a need for continuity on wards and there would be a ward manager in place and it was the role of management to keep track of what was going on.  It was highlighted that this was something that United Lincolnshire Hospitals NHS Trust needed to track.

·         In terms of the use of Discharge to Assess Residential beds, it was queried whether they were all in one place, and members were advised that they were spread around the county.  The aim was to have one in every locality, and officers were planning to review them to determine whether some were utilised more than others.

·         In relation to the conclusion, it was suggested whether the Committee could review the work again in one years' time, as some of the schemes needed more time to embed, and it was hoped that the benefits of this scheme would be seen the following year.

·         It was noted that in relation to the quote from the LIVES website (p.27 of the report), some people just needed a bit of company and to check they were ok after a fall, they did not all need to go to hospital. 

·         In terms of GP (primary care) streaming, those individuals who presented to an emergency department but did not need to see an acute specialist would be streamed to an alternative clinician.

·         It was noted that a full evaluation of the impact of the schemes was being completed by the University of Lincoln, and members would be interested to see the outcome of this work.  However, it would take another 18 months before the work would be completed.

·         It was requested whether an update on the work of the Hospital Avoidance Response Team could be brought back to the Committee at a later date.  It was noted that the team would be asked to come and talk to the Committee about their work.

·         It was reported that officers were working with colleagues across the system and Lincolnshire was performing quite well in terms of DTOC, but reducing the length of stay needed further attention. 

·         It was important that therapists visited people at home rather than just in hospital, as people would behave differently in hospital, for example with mobility as a hospital was an unfamiliar place, and at home they may have the space set up so to make it easier for them to move around (furniture may be placed so they were able to hold onto it and use it for support etc.)

RESOLVED

            That the Committee note the report.