Agenda item

Cabinet received a report providing an update on work to improve the reporting and management of Delayed Transfers of Care (DToCs) as well as an update on the national position.  The report sought to provide assurance for members that agreed interventions in this area were achieving the desired outcomes.

The Leader set out the background to the report.  In particular her referred to the following:

       i.        That work to manage and reduce DTOCs was crucial to ensure that patients were released from hospital at the earliest opportunity with the right support and interventions from social care services in place.  Unless patient transfers were conducted in a timely manner hospitals were negatively impacted and elective surgery delayed which had a human and financial cost.

        ii.            That DTOCs were currently recorded in two ways.  One, as the Department of Health requested they be recorded and another as the Association of Directors of Social Services (ADASS) suggested; the latter being seen to provide a more accurate picture for individual authorities.

The Cabinet Member for Adult Social Care, Mr Graham Gibbens further introduced the item for members.  He concurred with the comments of the Leader about the importance of the timely release of patients from hospital and reported that the Secretary of State and the Chief Executive of NHS England had also commented many times to the same effect.  He reminded members that one of the criteria for which the New Social Care Monies received in March had been awarded was to keep people out of hospital where possible and get patients released from hospital as quickly as possible where it had not been.  This would include support to the Domiciliary Care market to ensure that it is robust and fit for purpose so that lack of enablement services was not a reason for a delay in transfer of care.

He concluded that any DTOC and enablement work must be complimented by a strong preventative agenda.

Anu Singh, Corporate Director Adult Social Care and Health, spoke to the item.  She concurred with the views expressed by the Leader and by the Cabinet Member and sought to bring additional information to the attention of members present by focusing on not only the principles behind timely release from hospital and proper enablement packages but also to the numbers set out in the report.   In particular she referred to the following:

      i.        That it was important for members to consider the potential, significant, impacts of a failure to reduce DTOCs.

    ii.        That the ADASS recording method was not intended to replace the Department of Health national reporting method with an alternative but was required to manage DTOCs on a local operational basis. 

   iii.        National reporting figures were crucial to the reputation of the council, the council’s STP and to the determination of the level of IBCF funding that would be received.  In that respect the figures were moving in the right direction, difficulties with the way the figures were drawn together remained, but nonetheless they were improved and KCC was on track to meet national targets.

   iv.        That the direction of travel on the local data was also good and showed greater improvement than the national figures.  Historical issues remained and interventions had taken place to try to further positively impact on stubborn issues such as problems with recruitment to to domiciliary care market.

    v.        A focus on DTOC figures would encourage a broader consideration of important issues such as how the flow of provision could be improved as well as partnership working strengthened and the patient journey and related flow of investment eased.

The Leader suggested that numbers of cancelled elective surgeries would be a useful indication of a hospital becoming overwhelmed by A&E services. 

He also expressed his disappointment that planned investment in local care had been ‘set aside’ and urged decision makers to reconsider.  Ms Singh agreed and expressed concern that KCC was currently suffering reputationally as a result of this and other issues.

In response to a question Ms Singh confirmed that although some boundary issues made report difficult between the NHS and KCC the residence of any one patient would not affect the service received as the guidance on best practice which had been adopted, was national guidance. 

The Leader asked that reporting continue with further information to be included in the future, in particular on the direction of travel for DTOCs across the county and at individual hospitals.

It was RESOLVED

      i.        that the report be NOTED

    ii.        that a further report be RECEIVED in February 2018