Agenda item

To consider the current position for Delayed Transfer of Care (DToC) figures from across Cheshire East following the key recommendations made by this Committee at the DToC Spotlight Review in January/February 2017.

The Chairman introduced the item to the Committee.  The Committee considered the table of responses to the key recommendations published as part of the Delayed Transfer of Care (DToC) report following a spotlight review, by this Committee, last February. 

Jamila Tausif, Associate Director of Commissioning at South Cheshire & Vale Royal Clinical Commissioning Group (CCG) and Karen Burton, Clinical Project Manager Urgent & Emergency at Care Eastern Cheshire CCG were in attendance to answer any questions the Committee had in respect of DToC.

The Committee noted that the Home First model had been agreed and questioned if it was too early to see any improvement because of that.  Jamila clarified that the Home First Model was a different piece of work to the Discharge to Assess (D2A) that the CCGs had been working towards.  D2A was an NHS initiative that was about funding and supporting people to leave hospital, when safe and appropriate to do so, and continuing their care and assessment out of hospital. They can then be assessed for their longer-term needs in the right place which is when the Home First model would work in conjunction.

The D2A model was introduced into Mid Cheshire and Macclesfield last July, NHS England had set targets for both areas of 3.5%, Jamaila acknowledged that February had been a difficult few weeks with winter weather but Karen added that yesterday at Macclesfield hospital, the target had been 15 people and actual figures were 12.

The Committee asked if the current 7-day working arrangements for social workers was on a voluntary basis.  Jill Broomhall, Director of Adult Social Care Operations advised that staff were being asked if they wanted to change their working pattern on a voluntary basis but that further recruitment of staff would incorporate a shift pattern for a 7-day week.

The Committee asked if there was any impact on delays from patients waiting for home adaptations.  Jamaila advised that the Emergency Department discharge within four hours, and to date there are no significant delays.  Readmission rates are monitored to identify problems and establish if patients had returned home too soon.  Karen added that there were stringent governance arrangements in place to manage this situation.

The Chairman asked the Portfolio Holders to provide a verbal update on the funding formula for the CCGs.

Councillor Janet Clowes, Portfolio Holder for Adult Social Care and Integration advised that as a result of the DToC work, she had met in Westminster with Cheshire MPs who were receptive to the progress being made across Cheshire East.  The current funding formulas were calculated in 2011 using data from the previous year however there was ongoing discussion about the future of the CCGs for Cheshire East and a potential merging to create one larger organisation.  This would have an impact on future funding calculations by NHS England.

The Chairman noted many of the responses to the review had referenced strategic data reported into various internal boards within the CCG/NHS structures.  He asked that these reports and figures also came to this Committee to keep Members informed of progress.  Jamaila advised there was an A&E Delivery Board Performance Report that she will share with this Committee.

Nichola Glover-Edge, Director of Commissioning gave some supporting information from the Commissioning perspective.  There was work being done around the recommissioning of domiciliary care with both CCGs.  Care.co were an external company that had done research to determine the actual price of care.  This enabled Local Authorities to set market prices for sustainable care.  Councillor Clowes advised the Committee that the process of hiring independent, external advisors to broker appraisals and assess cost of care was standard practice and happened every two years.

Jill Broomhall, Director of Adult Social Care advised that the Rapid Response for domiciliary care had proved to be successful.

RESOLVED:

a)    That Jamaila and Karen be thanked for their attendance; and

b)    That Jamaila provide the A&E Delivery Board Performance Report to Helen Davies to be circulated to Committee Members.