Issue - meetings

The Overview and Scrutiny Committee will receive a joint presentation from the Integrated Care Board and the County Council on system pressures in Warwickshire.

The Committee received a joint presentation on system pressures in Warwickshire from Rachael Danter of the Coventry and Warwickshire Integrated Care Board (C&WICB) and Pete Sidgwick for the County Council.

The presentation covered the following areas:

• System pressures – some key facts
• Accident and emergency attendances
• Activity to support the system
• Number of occupied beds for all discharged adult patients in hospital for over seven days
• Supported discharges facilitated by Warwickshire Social Care. Slides provided this data for the period April 2022 - January 2023 by week, site and site & pathway.
• Discharge to Assess activity  
• Home based therapy
• Reablement
• Domiciliary Care
• Hospital Discharge Fund

Questions and comments were invited with responses provided as indicated:

·   Several members recorded their thanks for the presentation.

·   Councillor Holland noted the data provided on the low numbers of people awaiting care packages to be able to leave hospital, which showed this was an efficient service. The data on discharges he received as a hospital governor showed this to be a major concern for the Trust.  He asked what could be done to align the figures to give a common understanding.

·   Pete Sidgwick replied that operationally there was a good understanding. The challenges may relate to NHS England metric requirements around medical fitness for discharge. He had discussed the same issue with the Portfolio Holder, Councillor Bell. In broad terms the data reported by hospital trusts and the County Council were similar. Another contributor was where patients lived. Some patients at George Eliot Hospital lived in neighbouring areas and were included on social care data for Leicestershire or Coventry.

·   Reference was made to the Discharge Integration Frontrunner Initiative. This sought to streamline acute hospital discharges, the ask being to discharge patients within 24 hours of when they were deemed to be medically fit to do so. This could be very challenging both from a commissioning and operational perspective and an outline was given of the many facets which needed to be considered. That said, there was always room to improve.

·   Rachael Danter spoke about perceptions and what was actually required to enable patients to return safely to their place of residence.  Sometimes acute services may feel the process took longer than necessary, especially when those trusts were under pressure. The frontrunner initiative provided the way forward and whilst its target was challenging, it was believed it could be achieved.

·   Councillor Holland sought more information about NHS continuing care and onward treatment for people in their home, referring to recent announcements from the Secretary of State for Health and Social Care. This should assist earlier hospital discharge and an example was given for elective surgery procedures which may only require patients to be in hospital for a single day. He asked if there were perceived problems with delivering such care at home for both the NHS and Social Care.

·   In response, Officers advised this was known as ‘virtual wards’ with continued treatment in the home. Social Care was precluded from providing healthcare. However, when it  ...  view the full minutes text for item 5