Issue - meetings

This report provides the Committee with an overview of the purpose, scope and progress of South Warwickshire Foundation Trust’s Community Hospital inpatient review. It presents findings of the initial engagement as well as the future plan and indicative timeline for the review.

Katie Herbert introduced this item on behalf of South Warwickshire Foundation Trust (SWFT), to provide an overview of the purpose, scope and progress of its community hospital inpatient review. It presented findings of the initial patient, carer, stakeholder, and staff engagement as well as the future plan and indicative timeline for the review. There was a requirement to consult on substantial developments or variations in the provision of health services.

Sam Owen Head of Nursing for out of hospital at SWFT then took members through the detail of the report which covered the following areas:

Community Hospital Inpatient Provision

Background was provided on community hospitals and the facilities in the south of Warwickshire. Ellen Badger Hospital in Shipston on Stour had 16 inpatient beds and the Nicol Unit at Stratford Hospital had 19 inpatient beds. The bedded offer at the community hospitals was broadly split into two areas providing for acute discharge and admission prevention beds. There was currently no provision in the north of Warwickshire Rugby areas. Within those areas, patients’ needs were met via a mix of primary care, community and acute provision. 

The review of Discharge to Assess services

A system wide strategic review of discharge to assess (D2A) services was agreed by all local system partners in 2019. The report outlined this review which was now moving into its implementation phase. Recommendations within the review were to move towards a simplified, clear and fit for purpose D2A offer. Community hospitals formed part of that offer within south Warwickshire. A table within the report provided a breakdown of the different pathways available to patients at the point of discharge, including community hospital inpatient beds, which should account for no more than 4% of all discharges from acute hospital within the over 65’s population.

Hospital Discharge Policy 2020

This was one of the central policy drivers for the D2A review, setting out the responsibilities of service providers. The report included an outline of the original guidance, the ambitions within the hospital discharge policy and its supporting guidance. This approach to ‘Home First’ stated that ‘every effort should be made to follow home first principles, allowing people to recover, re-able, rehabilitate or die in their own home’.

The case for change

The community hospital review took place within the context of wider changes within both health and social care, the Integrated Care System (ICS), the development of out of hospital services, the wider availability of D2A services and the prevalence of preventative programmes. Community health/out of hospital services had developed and were able to support much higher levels of patient need with a focus on admission prevention and supported discharge. Therefore, community hospital provision should be reviewed within the context of this enhanced and broader community offer. Some patients went to community hospitals to die, but there were inpatient and outpatient hospice facilities available. A multi-agency audit of patients using the community hospital inpatient facilities was undertaken in the spring of 2021 and the findings were reported.

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