Agenda item

(To receive a report by David Boath (Performance and Intelligence Manager), which provides an update on the 2017/18 Quarter 1 performance)

Consideration was given to a report by the Executive Director of Adult Care and Community Wellbeing which provided an update on 2017/18 Q1 performance of the Adult Care Business Plan measures within the four Commissioning Strategies.

Theo Jarratt (County Manager – Performance, Quality and Development) introduced the report and explained that this report had been submitted to the Committee prior to the workshop arranged to take place after the meeting of the Committee in October 2017.  The aim of the workshop was to provide further understanding of the national reporting requirements for the Directorate and to shape future areas of performance focus for this Committee.

The report had, therefore, been themed around Hospital Services and focussed on the following areas:-

·       The major impact on Lincolnshire residents;

·       The prime government priority area for Health and Social Care; and

·       The priority area for the Council and its NHS partners in terms of budget and activity.

Michelle Colbourne (Area Manager – Hospital Teams and Customer Service Centre) was invited to introduce the section on Hospital Services which was pertinent to the theme of this meeting.

The Chairman invited the Committee to ask questions on this section of the report and, during discussion, the following points were noted:-

·       Demand on hospital teams had increased and, as identified on page 12 of the agenda, 7609 new requests for support from the Council following discharge from hospital had been made.  This had increased on the previous year by 700 requests;

·       It was clarified that intermediate care was nursing and therapy support, provided by the NHS, and reablement care was social care provided by the council;

·       Performance of the reablement services provided by Allied Healthcare (commissioned by Lincolnshire County Council (LCC)) and Lincolnshire Community Health Services (LCHS) NHS Trust (commissioned by the Clinical Commissioning Groups (CCGs)) was discussed.  It was advised that the main reason for the lower performance of LCHS was the shortage of nursing staff, occupational therapists and physiotherapists.  Despite previous suggestions to the CCGs to consider a pooled-budget commissioning arrangement with LCC this had been declined.  The Committee asked that a referral be made to Councillor Mrs S Woolley (Executive Councillor for NHS Liaison and Chairman of the Lincolnshire Health and Wellbeing Board) to consider if this matter could be pursued by the Health and Wellbeing Board;

·       It was reported that Lincolnshire required 250 nurses to be able to cover basic service provision but this was near impossible in the current climate;

·       It was expected that CCGs would ask Adult Social Care to arrange homecare and residential care on their behalf.  A report would be presented to the Committee in early 2018 giving further information;

·       Clinical evidence suggested that if a person stayed at home 90 days after discharge from hospital then it was likely that they would remain at home hence the significance of the national performance measurement of "People Still at Home 91 days after Reablement";

The County Manager – Performance, Quality and Development continued to present the report where it was reported that Delayed Transfers of Care (DTOC) was expected to receive national attention and ministerial interest over the winter period therefore it was suggested to add this to the Work Programme as a regular item. 

The Committee was given a demonstration of the LG Inform website which provided details and figures of the DTOC figures for each authority.  It was reported, however, that figures would only appear if they had been signed off in the hospitals.  Members were encouraged to look at the site and, in particular Stoke and Cumbria by way of a comparison with Lincolnshire.  http://lginform.local.gov.uk/reports/view/lga-research/quick-view-dtoc-summary-delayed-days-for-a-single-authority-1?mod-area=E10000019&modify-report=Apply

During discussion, the following points were noted:-

·       The provision of convalescent facilities was suggested as a method of alleviating pressure on DTOC figures within the county;

·       Analysis undertaken during the development of the Lincolnshire Health and Care (LHAC) programme had found that if people lived close to a hospital then they would utilise the services there but if they did not live close by they would find alternative provision, suggesting that the availability of a service would predetermine it's use;

·       The statistics given were based on the registered home address and were attributable to the GP with which patients were registered.  Should the patient leave Lincolnshire and attend a hospital out-of-county, it was confirmed that the money would follow that patient, particularly for cases of specialist surgery; and

·       It was confirmed that Grantham Hospital remained an Acute Hospital at this time.

RESOLVED

1.    That the report and comments be noted;

2.    That the Lincolnshire Health and Wellbeing Board be asked to investigate the possibility of a pooled-budget commissioning arrangement between the Clinical Commissioning Groups and Lincolnshire County Council in relation to reablement services; and

3.    That Delayed Transfers of Care (DTOC) be added to the Committee's Work Programme as a regular item.