Agenda item

To receive and note a report from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing on the background to delayed transfers of care.

1.            Mr Ireland introduced the report and referred to the media coverage of crises in hospital services over Christmas and the new year.  Although admissions of elderly and frail older people to hospitals would usually rise at that time of year, both the number of patients and the severity of their conditions had continued to increase beyond the holiday period.  At a recent meeting of adult social care and clinical commissioning group partners, Kent’s hospitals were judged to be holding up well against great strain. National media coverage had reported that no hospitals had met their targets. He explained that a dedicated social work team was now in each acute hospital in Kent and, in a three week period, had been effective in diverting 12 people from being admitted unnecessarily.  There was also much activity to speed up placements and arrange domiciliary care packages, although the closure of two care homes during 2014, losing 60 care beds, had inevitably had some impact. 

2.            Ms Duff added that, as the lead officer for urgent care, she and area managers had been involved in taking on additional care workers to support enablement services to allow people to return home from hospital sooner.  Response to the request for additional workers, and existing workers to take on extra shifts, had been good.  She gave figures for the number of admissions during one week in December at the main East Kent hospitals, as follows: Queen Elizabeth the Queen Mother – 165, Kent and Canterbury – 222, and William Harvey - 208. The average weekly number of admissions was usually 50 to 60. To boost the number of short-term beds available, care homes had been asked to identify and offer any spare capacity they could.  To illustrate the level of delayed discharge in East Kent, Ms Duff reported that, in the week of 18 December, there were 40 delayed discharges among clients for whom the County Council had responsibility; 31 of these delays were attributable to a health cause, 8 to social care causes, eg being able to find continuing care placements, and 1 to joint causes. Hence, none of the increase in delays was due to social care causes.

3.            Mr Ireland and Ms Duff responded to comments and questions from Members, as follows:-

a)      concern was expressed that, whereas a patient’s discharge would once have been planned as soon as they were admitted to hospital, this practice may have been discontinued. Ms Duff confirmed that the usual practice was still for a plan of the patient’s likely acute care needs to be drawn up upon admission and for this to shape their hospital stay.  New integrated discharge teams, based within hospitals, would co-ordinate services and resources to plan a patient’s discharge.  The speaker added that the enablement team in her area was very successful;

b)      the Director and staff were thanked for their work in co-ordinating hospital discharges over the busy Christmas and new year period. At a regional Health Overview and Scrutiny Committee meeting on 14 January, it was highlighted that, although three hospitals in the region had had to declare emergency status, Kent’s hospitals had managed to avoid this by close joint working between the NHS and adult social care staff;

c)      another speaker endorsed this and offered to share a presentation that she had recently attended which highlighted the dangers of elderly people staying in hospital for extended periods; and

d)     it was suggested that, once the 2014/15 winter had passed, the experience and performance be evaluated and any lessons learnt be highlighted so the County Council and its partners could prepare for the following winter.  Mr Ireland supported this suggestion and added that, as no severe weather had so far been experienced this winter, it was not possible to predict what experiences might yet be to come. He explained that there was a delay in official data being collated and released and that NHS England were not able to provide validated figures beyond the end of November 2014. However, the County Council kept its own, un-validated, figures and monitored activity and costs of activity very closely.

4.                  The Cabinet Member, Mr Gibbens, thanked Members for their comments. He explained that he had requested the report to allow Members to have an opportunity to discuss this highly topical issue and hoped that they had found it reassuring.  He thanked the adult social care and hospital teams for their work in avoiding the need to make unnecessary admissions to acute services.  He asked any Member who had concerns about the issue to contact him directly.

5.            RESOLVED that the information set out in the report, and given in response to questions, be noted.