Agenda item

URGENCY

The Leader advised that this item was urgent in the light of the ongoing winter problems within the NHS especially as it coincided with the circulation of two virulent influenza outbreaks.  He indicated that it was important for the Cabinet to understand the pressures on hospitals and the social care market and on how social services were responding.

(Item 8 – Andrew Ireland, Corporate Director of Social Care, Health and Wellbeing).

This matter had received a great deal of media attention and was therefore drawn to the Cabinet’s attention.  Cabinet were invited to consider what had been done by health and social care services to care for local residents. This paper was intended to update Cabinet on related issues including the hospital delayed discharges position in Kent.

The Leader opened the discussion by reminding Cabinet Members of the numerous and complex issues behind the current crisis including:

• The level of cuts in local government funding compared with the increased demand and whether this needed to be recalibrated against the increases in foreign aid which was due to be significantly increased.
• The need for the Government to revisit the best of the Dilnot recommendations
• The need for the care markets to expand and not contract which would need for the market to be financially viable
• The need to ensure that there was adequate funding for state funded adults as well as those in the independent sector both in domiciliary and residential care
• The Sustainable Transformation Plan that identified that 30% of hospital beds could be freed up for better and cheaper treatment of people in their own homes through greater use of community based services
• Noting that the second stage of funding under the Better Care Fund was part of the “flat cash” funding for local government.

Andrew Ireland, Corporate Director of Social Care, Health and Wellbeing, formally presented the report and raised the following points:

• The current winter crisis was worse than usual in terms of demand including pressure on accident and emergency departments
• The extent and seriousness of illness within many of the older patients attending hospital
• Concern about the flow of patients through hospitals 
• Measures that had been implemented – more staff in hospitals, investment in schemes to facilitate discharge, work with partners in emergency plan exercises, seven day working of social care teams, support for increased enablement at home, step up/step down beds, extra care sheltered housing
• Recognition that the NHS had managed to reduce bed occupancy to 85% before Christmas 2016 which had helped prevent the crisis from being even deeper

• In terms of markets there was a real issue in terms of domiciliary care albeit with geographical variations with agencies unable to recruit sufficient staff
• Looking at alternative models for commissioning domiciliary care
• That the problems within this area were fundamental and long term and were not likely to be able to be fixed in the short term

Cabinet Members endorsed the issues raised in the paper

It was RESOLVED: