Agenda item

The report was presented to members and the following key points were highlighted in terms of explanation of performance against targets:

·           We are focussing on person centred care and delivering the outcomes people want. That can be difficult to qualify against Welsh Government performance indicators for ‘delayed transfers of care’.  Some of the problems in reaching targets for having care packages in place within a specific timescale are related to complex cases where there may be a need to re-house a person.

·           Hospitals tend to err on the side of caution and admit people to hospital and keep them in for a period, when we feel they may be better cared for in their homes. The question is what preventative work could help people to stay well at home so that they do not need to be admitted to hospital.  The ‘Homefirst Project’ is a key example of this.

·           We are engaged in effective partnership working with health to increase hospital discharges.  A team is in place at the Royal Gwent and Nevill Hall to ensure that the person has the right support to enable them to leave hospital and avoid unnecessary lengthy stays.

·           A key area of concern is the target around adult safeguarding ~ we have seen an increase in concerns, which has put pressure on the service. It is positive that the ‘duty to report’ has led concerns to be taken forward and it does demonstrate that awareness raising is working, however, capacity will need to be managed going forward and will feature within our budget discussions.

Challenge:

·           The report indicated that the delayed transfers of care are featuring more in the community hospitals, with the brokerage of care hours cited as a reason. The joint discharge team in larger hospitals appears to be effective. Are these in place in community hospitals too?  And if so, what are the reasons for higher delayed transfers of care in community hospitals?

The teams are in place in community hospitals. The reason for the higher levels in community hospitals is because these hospitals deal with more complex cases. The primary hospitals have discharged people to the community hospitals because they have complex needs and require specialist support in order to be able to go home. The occupational therapists and physio teams discharge people as soon as possible and in many cases, people are able to go home, but sometimes complex adaptations may require the person to move to alternative accommodation, but we try to avoid this as far as possible.

Outcome and Chair’s Conclusion:

The committee accepts the explanations around the service’s performance in terms of ‘delayed transfers of care’ from community hospitals being due to complex cases.   We recognise that this is not an issue solely for Monmouthshire and that there are concerns for the care sector nationally.

In terms of the increase in adult safeguarding concerns, we recognise this as an issue of demand is exceeding capacity.  We request an email from the Chief Officer as to how we are addressing this, given that we are in lower performance bracket in this regard. We understand it’s a changing picture and that this issue is not going to become easier to solve, but would like to be reassured that mitigations are in place.