Agenda and minutes

Agreed as an accurate record.

It was confirmed that all items on the agenda would be considered in public.

Consideration was given to a draft scoping report on the Committee's major review on Hospital Discharges.

The Council's Health & Social Care Integration Manager and Head of Social Work attended the meeting and provided Members with the context to the review.

The aim of the review was to examine the discharge process from hospital and how people were supported into the least restrictive care setting in order to maximise their independence and safely meet their needs.

The focus of the review would be on Hillingdon Hospital where around 80% of the people admitted were from within the Borough of Hillingdon. Of those admitted as emergencies, almost 30% were of people aged 65 and over and registered with Hillingdon GPs.

The Committee agreed that this age profile would be the focus of the review.

Current context

The Committee was informed that changes in the levels of activity in the last two years had increased patients delayed transfer to care. Reference was made to research which showed that the longer an elderly person was in hospital, they were more likely to become increasingly confused, and there was also an increasing risk of them contracting a hospital acquired infection.

In addition, delays in discharging people who were medically fit added increasing pressure on hospital bed provision, which could lead to higher costs.

Reference was made to NHS England (NHSE) who had reported that nationally, everyday more than 6,000 patients who were well enough to leave hospital were unable to do so because of insufficient local care models. With a 23% rise of delays in discharge nationally since June 2015, “joined-up care” remained the single most important feature for ensuring greater patient safety and efficient hospital discharge planning.

The National Audit Office (NAO) estimated the cost to the NHS of older patients in hospital beds, no longer in need of acute treatment, totalled £820 million every year.  Longer stays in hospital also led to increased social care costs.

Preventative Initiatives

The most effective method for addressing hospital admission was to prevent hospital admissions from occurring in the first place.

·         Development of an anticipatory model of care for older people

This was where older people who had been identified as being at risk of hospital admission, were invited into their GP surgery to explore the completion of a care plan.

This was to identify any interventions which might prevent an escalation of need. 

For people with more complex needs, a multi-disciplinary team (MDT) approach was taken. For example, an approach which would involve professionals from different health and care organisations, seeking to identify solutions which would prevent or delay further escalation of need and enable the management of the person in their usual place of residence.

H4All (a consortium of local third sector organisations) played a crucial role in this initiative.

·         Better Care Fund Plan (BCF)

 A key priority of Hillingdon's 2016/17 BCF was the prevention of admission to hospital and this was reflected in its eight schemes that looked at issues such as  ...  view the full minutes text for item 19.

To be provided with an oral update on the Committee's review on Stroke Prevention.

Members were informed that officers were in the process of summarising the information which had been provided for the review, and establishing gaps which required further investigation from the Committee.

For the next meeting, the Committee would be provided with a progress report on the review so far.

To receive officer responses to the questions which Members asked on the Safeguarding Adults Partnership Board Annual Report 2015/16.

The Committee was provided with responses from the Chair of the Board to a number of questions which were asked on details provided in the Annual Report.

The Committee asked if the Chair of the Safeguarding Adults Partnership Board be invited to a future meeting to provide more details on some of the areas raised by Members.

Noted.

Noted.