Agenda item

This report provides an update to a report presented to the Health and Wellbeing Board on 28April 2016 which set out the policy context and high level strategy for the Kent and Medway Transforming Care Partnership. The report sets out:

1. The background to Transforming Care and the Kent and Medway Transforming Care Plan.
2. The required focus on addressing inpatient trajectories, which currently fall outside of national planning assumptions.
3. Proposed arrangements for managing the flow of funds from NHS England to local health and social care economies to support individuals stepped down from inpatient settings to the community.
4. Short term investment through Transforming Care grant funding to support specific programmes of work in Medway and Kent to ready the system to support identified patients in the community.

Discussion:

The Partnership Commissioning Programme Lead, Graham Tanner, introduced an update on the Transforming Care Plan (TCP). The Plan related to the development of services for people with a learning disability and/or autism who displayed challenging behaviour.

The Kent and Medway Transforming Care Partnership was one of 48 partnerships covering England. Each partnership covered an area with a population of greater than one million people. The Kent and Medway Transformation Care Plan (2016-19) had been submitted to NHS England in May 2016. This included separate Kent and Medway delivery plans.

Kent and Medway were required to prioritise the reduction of inpatient numbers, due to current trajectories falling outside of the planning assumptions contained within the Transforming Care National Plan.

At the start of September 2016, there were a total of 86 TCP inpatients, with 11 of these being located in Medway. There were 12 out of area patients. However, even maintaining these numbers depended upon there being no new admissions. NHS England expected that the inpatient bed figure for Kent and Medway should fall within the 45 to 59 range at any one time. A refresh of the TCP would be required to outline how the figure would be reduced to fall within this range by April 2019.

It was noted that patients who had been in hospital for more than five years were eligible for a ‘dowry’ to fund the cost of their inpatient bed.

Medway had received extra funding for a Complex Case Coordinator to work across health and social care. Funding had also been awarded for post-diagnostic support in relation to autism. Some Child and Adolescent Mental Health Services (CAMHS) funding would be available to provide short term safe accommodation in order to prevent hospital admission. The TCP had also been awarded funding for forensic outreach work.

Officers advised that an update on the TCP would be provided at the next Health and Wellbeing Board in February 2017.

Members of the Board raised a number of issues which were responded to as follows:

·         Update on Transforming Care Plan at next meeting: It was questioned whether the update to be brought to the next meeting of the Board would include how service provision pathways between services could become more ‘joined up’ and how gaps identified in the system of the system of support across the wider TCP area would be addressed. Officers advised that the update would include this information and also an update on the planned review and restructure of adult social care. Work would be undertaken to map local provision against the National Plan.

·         Consultation: Consultation in relation to learning disability and autism services in Medway was due to commence during November and would last 12 weeks.

·         Location of patients: Concerns were raised that vulnerable people were being cared for away from their home area. The need to create a complete package of care and ensure that this provided the best care possible for patients was also highlighted.

Decision

The Board:

a)    Noted the report and ongoing progress to ensure that the principles of the national Transforming Care programme and Building the Right Support were realised locally.

b)    Agreed a quarterly reporting cycle for updates on Transforming Care, with a further report to be considered in February 2017, which would set out in more detail the financial plans and proposals outlined in this report.