Agenda item

The new integrated hospital discharge model had resulted in significant progress regarding the evidence based approach.  The report provided a mixed picture whereby the DTOC performance had been good but other measures contributing towards this had not been quite so successful.  A straight line projection would result in there being an outturn of 7,412 delayed days in 2017/2018 which was 1,925 days below the 9,337 delayed days ceiling imposed by NHS England.  Overall, the Board felt that the targets being achieved were more important than those that were not. 

Consideration was given to the number of hospital admissions from care homes and whether there was an underlying default risk-averse position of sending residents to hospital.  It was noted that HCCG was looking into this issue and it appeared that there was a clear correlation between the management of a home and the number of hospital admissions.  To address this, HCCG had been working with nursing homes in the Borough and had approved the creation of a GP visiting team for these homes.  It was noted that the Partnership Care Homes Group met on a monthly basis and that the figures reported were based on raw bed base numbers.  Consideration would need to be given to how this information was reported to ensure that the data could be compared usefully. 

It was suggested that further work was required to investigate the impact of ambulance conveyances on Hillingdon Hospital and it was agreed that an update be provided at the Board's next meeting.  Although the emergency admission rate had increased, A&E attendance levels had remained largely the same.  It was suggested that the opening of the Frail and Elderly Unit at the hospital may have contributed towards this.  Consideration would need to be given to the purpose of this Unit and whether the service provided the best possible outcomes for residents. 

The Board was pleased with the progress that had been made in Hillingdon with regard to system improvements.  It was noted that sheltered housing provision at Grassy Meadow and Parkfield would be available in the summer and would contribute towards this continued progress. 

The Health and Wellbeing Board agreed to note the Carers' Memorandum of Understanding which would be considered by the Council's Cabinet and the HCCG's Governing Body in Q1 of 2018/2019.  If required, the Health and Wellbeing Board would reconsider the item and take any action as needed.

The position to the end of December 2017 showed that an average of 89% of people were still at home 91 days after discharge (against a target of 88%).  This performance was a strong indicator of the level of independence exhibited by residents. 

It was noted that staff had had to work hard through the recent extreme weather conditions experienced in the Borough.  The Board felt that this effort should be recognised. 

RESOLVED:  That the Health and Wellbeing Board:

1.    noted the progress in delivering the plan during the Q3 review period;

2.    noted the development of a Carers' Memorandum of Understanding containing the seven principles set out in the report as the basis for an updated Carers' Strategy for 2018/21; and

3.    delegated authority to the Council's Corporate Director of Adult, Children and Young People's Services, in consultation with the Chairman of the Health and Wellbeing Board, the Chairman of Hillingdon Clinical Commissioning Group's Governing Body and the Interim Chairman of Healthwatch Hillingdon's Board, to agree revised Better Care Fund targets for 2018/19, subject to advice about deliverability from the Council's Corporate Director and Hillingdon Clinical Commissioning Group's Chief Operating Officer.