Agenda item

Cabinet received a report providing an update on Delayed Transfers of Care (DToC) since the December 2017 Cabinet report which looked at the work to improve reporting and management of DToC; as well as providing an update on the national position and assurance that agreed interventions are working.

Mr G. Gibbens, Cabinet Member for Adult Social Care, introduced the item for members.  He acknowledged the importance of the matter of DToC and assured members that the relevant government Minister was equally interested in the matter and had put a Written Statement to the House of Commons on 3 July 2017, confirming that emphasis and the necessity of the NHS and local government working together to make faster and more significant progress on Delayed Transfer of Care (DToC).

He confirmed that robust monitoring continued to take place weekly with an opportunity for daily updates.  Although some complexities of recording and comparing data between the Council and the NHS remained, he was pleased to report a positive improvement in DToC figures which was a reflection of the hard work between agencies and the resulting reduction in DToC through social care considerations was particularly welcomed.

He offered members a further update report in the spring / early summer.

Ms Anu Singh, Director of Adult Social Care, reported that 3 major shifts had occurred in relation to DToC, as follows:

1.    Different leadership behaviours had been put in place across the system with Chief Executives and other senior officers taking daily calls to look at patients on a case by case basis where problems had occurred and the identifying factors which needed to be addressed in order to move those patients on.  Where new approaches were most needed the NHS has directed specific officer support as had occurred in East Kent.

2.    Data was being recorded and used differently; there was now a robust, joined up, system for recording and utilising data in the acute setting and work continued to replicate this success in the area of mental health where different challenges existed.

3.    Investment in the reduction of DToC had been facilitated by access to national funding and directing local resources differently and in a very targeted way. 

She was pleased to report significant reductions in DToC from this time last year as a result.

In response to comments from the Leader regarding the poor performance in East Kent, Ms Singh reported that NHS England had appointed Dr Anne Rainsberry, who had previously been the regional director of NHS London, to oversee the hospitals run by the East Kent University Hospitals Trust and an Integrated Programme Management Office had also been created.  Joint diagnostics had been undertaken, agreement reached on the problems at hand and joined up work had begun on resolutions which were already starting to yield improvements in the DToC figures. 

Me E. Hotson, Cabinet Member for Corporate and Democratic Services, welcomed the improved figures reported and in response to his question Ms Singh explained that integrated discharge teams had received investment and now spent time in and out of hospitals as part of a wider team, investment in the market had allowed more flexible step-down provision and the improved use of data had all been effective interventions that had helped staff to work differently and improve DToC figures accordingly.

It was RESOLVED that

1.    the robust performance dashboard that continues to be used to report and to manage performance locally be NOTED;

2.    the impact of the interventions on social care delays and in some health delays and the ongoing and escalated pressures that are being managed be NOTED;

3.    the issues with the National and local reporting and the work to reduce this through local teams and adopting a regional position be NOTED.

4.    A further report be received on the matter in the spring / summer, as appropriate.