The national ‘Hospital Discharge and Community Support Guidance’ (2022) outlines how NHS bodies and local authorities should plan and deliver hospital discharge and recovery services from acute and community hospitals. The Guidance reiterates the importance of adopting a ‘home first’ approach to ensure that individuals being discharged from hospital are supported to return home (to their usual place of residence) wherever possible.
This report updates the Health and Adult Social Care Scrutiny Board on Solihull Home First progress achieved to date and next steps. It also provides an opportunity for Scrutiny Board members to comment on this.
The Assistant Director for Service Delivery provided a presentation, updating Members on Solihull Home First progress achievements to date and proposed next steps.
Members raised a number of queries and observation which, in summary, included the following:
· A Member queried whether any benchmarking or learning from other areas had informed Home First.
· The Assistant Director for Service Delivery detailed how, nationally, a range of indicators relating to the percentage of people expected to be discharged onto each discharge pathway were provided on the use of different hospital discharge pathways and Solihull was performing well against these.
· The Chief Officer for Out of Hospital Services, UHB, explained how they recorded and reviewed the volume of patients who had a right to reside in hospital – as well as those patients who may benefit from some form of community support. They also reviewed the volume of patients who used hospital discharge services and didn’t subsequently need any form of longer-term support, to understand effectiveness.
· A Member queried how the hospital discharge and recovery services took into account the patient and carers’ emotional wellbeing. They also emphasised the range of services and support in place and queried how this could be clearly communicated.
· The Assistant Director for Service Delivery explained how everyone leaving hospital would have a care co-ordinator, a single point of contact for support, as well as signposting to the relevant service. The Assistant Director for Strategic Commissioning and Partnerships detailed the role of the Carers Trust Solihull, who delivered a range of support, information and advice.
· A Member queried the services available when carers were no longer able to provide support and questioned how quickly this could be introduced.
· The Assistant Director for Service Delivery explained how, through the Carers Trust, people were encouraged to establish an emergency care plan for such instances. The Adult Social Care Duty Team also provide support on the same day if needed, alongside the Emergency Duty Team for out of hours support if needed.
· A Member noted that, as part of the community therapy to support admissions avoidance and reablement, people may require physiotherapy. They queried whether sufficient capacity was available locally to provide this within a reasonable timeframe.
· The Associate Director of Delivery and Development, BSOL ICS, detailed the focus upon ensuring physiotherapy capacity across all pathways and settings. They had also looked at flexible working arrangements to support recruitment and increase capacity.
· A Member raised the shared care records, noting the volume of staff who may have access to this.
· The Assistant Director for Service Delivery explained how they had established a Shared Care Record that could be accessed by staff supporting care arrangements, including Physiotherapists, Occupational Therapists, Nurses, and Social Workers. Everyone accessing the system needed to adhere to confidentiality rules, and only access information they should be accessing. It was possible to conduct audits, to identify which records staff had accessed. Privacy notices had been published for Adult Social Care and a communications plan was implemented to raise awareness of the Shared Care Record, and the process for opting out of this if people wished. In response to a Member query, the Assistant Director for Service Delivery confirmed she would establish whether an ‘easy read’ version had been developed for this.
The Health and Adult Social Care Scrutiny Board:
(i) Noted the update on Solihull Home First progress to date.
(ii) Requested that the key points raised by Members be taken into account as part of the future delivery of Solihull Home First.