Issue - meetings

Hospital Discharge

Meeting: 21/09/2022 - Adult Social Care and Health Overview and Scrutiny Committee (Item 6)

Hospital Discharge

The Committee will receive a joint presentation on hospital discharge from health and the county council. This will include Discharge to Assess and Complex Discharge Pathways.

Additional documents:

Minutes:

The Committee received a joint presentation from Laura Gibson of George Eliot Hospital (GEH), Helen Lancaster of the Coventry and Warwickshire Integrated Care Board (C&WICB), together with County Council officers, Zoe Mayhew and Denise Cross. This presentation on ‘Ambulance Turnaround, Winter Plan & Discharge Pathways’ included slides on:

 

  • George Eliot Hospital NHS Trust. A slide showing data for this hospital trust including bed capacity, emergency department attendances, average data for admissions, discharges and ambulance visits.
  • Ambulance Handover, showing the weekly numbers of transfers taking over one hour for the period March to August 2022.
  • National Pathway Definitions. There are four pathways (0,1,2,3). This slide showed the proportion of people in each pathway and a definition of the respective discharge arrangements.
  • Hospital Social Care and Reablement. This provided data for such things as referrals, increasing trends, reablement visits and the provision of equipment in the home.
  • Social Care Domiciliary Care. This reported the data on referrals and increasing demands, domiciliary care pathways and typical waiting times for packages of care to begin.
  • Length of stay - graphs showing hospital stays of over 21 days and the numbers of patients who did not meet criteria to reside in hospital.
  • Pathway issues which identified contributors to delays.
  • Joint actions, a slide which outlined some of the current initiatives being implemented.
  • What does the future look like? A series of key outcomes to provide a process that was person-centred, strengths-based, and driven by choice, dignity and respect.
  • Winter plan 2022/23.
  • Core objectives and key actions for operational resilience
  • New national board assurance framework key metrics.
  • System wide planning aims. These sought to ensure there were no delays throughout the care pathway, maintaining services, ensuring sufficient bed capacity, admission prevention through use of alternate treatment services, timely discharge, partnership working and workforce wellbeing.

 

Debate took place on the following areas:

 

  • Officers were thanked by several members for the presentation.
  • The objectives were welcomed, with questions on the expected timeline for their completion and progress made to date. Some work was already underway, but a detailed timeline could not be provided. The challenges of the forthcoming winter period were not yet known, and some objectives may need to be reviewed, but the experience of partnership working over the last two years and moving care away from acute settings were key aspects raised.
  • The system approach to addressing delayed discharges was welcomed. A point was made that all NHS services should have a focus on discharge, with specific reference to delays due medication provision.
  • It was noted that private ambulance services were used, together with Warwickshire Fire and Rescue Service ‘hospital to home’ scheme. 
  • Discussion about the collection of medical equipment that was no longer required, so that it could be reused by other people. Officers explained that the recycling of some smaller items was not feasible either for cost or infection control reasons. There were periodic campaigns where people could return equipment to designated sites and the service provider, Millbrook Healthcare could be contacted to collect  ...  view the full minutes text for item 6