Agenda item

This briefing is a follow up to the report on the complete care pathway that was presented to Overview and Scrutiny Committee on 17 December 2015. It provides the Committee with the latest update on the situation relating to discharge planning.

Discussion:

The Deputy Director, Children and Adults introduced the report on discharge planning and emphasised the importance of this in connection with support for the hospital.  He referred to the report considered by the Committee in December 2015 and stated that this report updated on that position.  He also mentioned that the Chairman, Vice-Chairman and one of the opposition spokespersons had met recently with the lead for the Emergency Care Improvement Team at the hospital which had been helpful in setting the scene with regards to the pressures felt across the health and social care system.

The Discharge Lead at MFT stated that the figures for discharge from the hospital were checked weekly and averaged 25-35 a week.  The numbers of delays attributable to social care had gone down but the numbers of people waiting for continuing healthcare/nursing care had increased. 

It was stated that the formerly named “Home to Assess” scheme would in future be referred to as “Home First” and this would be commenced on 4 April 2016.  Responding to a query the Discharge Lead at MFT stated that the scheme was a multi agency one, led by Medway Community Healthcare.  The plan was for an Occupational Therapist to attend the patient at home within 5 hours of discharge and assess what was needed.  Once this was established plans would be put in place for them to receive the necessary care.

The Deputy Director, Children and Adults confirmed that it was the Assistant Director, Partnership Commissioning who was the lead on commissioning of the “Home First” scheme which reduced down the need to engage with 18 organisations down to two, which should assist with reablement.

Members welcomed the introduction of the “Home First” scheme and stated that they would be keen to learn how the success of the scheme would be measured to ensure it was having an impact on reducing re-admission to hospital.  The view was put forward that, compared to similar authorities, Medway had fewer extra care homes.  The Deputy Director, Children and Adults stated that work was being undertaken with Oxford Brookes University on housing research and that more work needed to be undertaken to see how assistive technology could help people to remain independent.  He also stated that the “Home First” scheme was similar to one which had been successful in Gloucestershire but had been adapted specifically to Medway.

There was a discussion about the difficulties around the fact that if someone chose a specific nursing home which had no vacancies this could bring about delays in hospital.  The Discharge Lead, MFT stated that work was being done to ensure that in such cases the families are given advice about similar properties in the area  that were able to offer a place.  The point was made that there was sufficient numbers of beds in care homes in Medway although if the patient had dementia this could often bring about difficulties in placing them. 

The Deputy Director, Children and Adults stated that the mobilisation of the hospital based Discharge Team had improved communication within the hospital.

Further to a query about whether early discussions took place with relatives about care home facilities, the Discharge Lead, MFT confirmed that early discussions did take place with relatives where it was clear that the patient was unlikely to be able to return to their home and would be in need of residential care.

Decision:

The Committee requested a briefing note on the implementation of the “Home First” scheme and an update on nursing home capacity.