Agenda item

The Committee was provided with a summary of the evidence received for the three witness sessions for the Committee's review into Hospital Discharges.

The Council's Health & Social Care Integration Manager reported that the key themes which came out of the review were that services were required to be in place to enable elderly patients to be discharged quickly from hospital. Improvements were required in communication between all agencies, to keep the patient and their families informed.

Discussion took place around the themes of the review and it was agreed that communication to the patient was the key. The involvement of families, advocates, and Age UK for example, was very important.

The Committee noted that for many elderly patients admitted to hospital, it was a traumatic experience, so maintaining their mental health was very important. Keeping the patient and their families updated, with clear and consistent information was important in terms of keeping patient's positive, and enabling them to be discharged quicker from hospital.

Support was also required when the patient had been discharged from hospital to their home.

The Corporate Director of Adults, Children & Young Peoples Services explained to the Committee that the Council had a statutory duty to make assessments on individuals' social care needs. However, a balance had to be made in terms of the care package the individual needed, and what was available in the market. Cost considerations had to be taken into account, as part of the decision reached, and the care package offered.     

Subject to further discussions with officers and the Chairman of the Committee and the Labour Lead, the following suggested draft recommendations of the review were agreed:

1.         a) That clear information about the discharge process is developed for and with people admitted to hospital and their families so that they know what to expect.

b) That this information is provided to patients on admission as agreed through a joint working policy.

2.         a) That a joint working policy across all partners involved in the hospital discharge process is developed to clarify the roles and responsibilities of the appropriate teams within each organisation and to ensure consistency of approach.

b) That the joint working policy is formally endorsed by each organisation.

c) That briefings with staff across organisations on the content of the agreed joint working policy are undertaken.

3.         That partners explore options for delivering a more integrated intermediate care service that ensures that people admitted to hospital are supported to go home by the most appropriate professional first time and that the number of hand-offs between different organisations is reduced.

4.         That partners explore affordable options to enable people who are medically fit for discharge are able to step down from hospital without the need to be admitted to a care home.

5.         That partners explore affordable options that will ensure an appropriate supply of care home places to address the needs arising from Hillingdon's changing population.

6.         That partners explore affordable options for ensuring that people admitted to hospital and their families have access to advocacy to support them in making informed decisions about how their future care needs will be met, including the care setting.

7.         That Healthwatch be requested to undertake a further review of the patient experience of the discharge process at Hillingdon Hospital in a year's time.

8.         That a progress report be provided to the Cabinet Member for Social Services, Housing, Health & Wellbeing (and then to the Social Services, Housing and Public Health Policy Overview Committee) that includes an update on the above recommendations as well as:

·         Number/% of Delayed Transfers of Care in Hillingdon Hospital attributed to patient/family choice;

·         % of Continuing Healthcare assessments taking place in a hospital setting;

·         Number/% of patients discharged before midday 7 days a week.

The Committee thanked officers for their support during the review, together with the witnesses who had helped the Committee form the recommendations.

RESOLVED

1. That the information provided at the meeting, together with the draft suggested recommendations, be noted, and be taken forward as part of the review.

      2.  That approval of the draft final report be agreed by the Chairman of the Committee and the Labour Lead, in consultation with officers.