Issue - meetings

(19:00-19:30)*

For the Committee to consider and scrutinise the local response to the national Hospital Discharge Policy and the Home First approach.

The Committee received an update from Principal Officer for Planning and Quality Assurance who presented the report on the Home First Programme, including an update on Better Care Fund, concerning the new hospital discharge service and the changes, activities and learning yielded from the patient experience.

The main points of the presentation were as follows:

•         The Better Care Fund planning and reporting has been paused during the COVID pandemic.

•         The new national discharge policy and operating model commenced on 19 March 2020 in response to the pandemic. The model facilitates hospital discharge when a patient no longer reaches criteria to stay in hospital. New and additional care would be fully funded by the Government during this period and the hospital discharge process would operate from 8am-8pm 7 days a week, working in a multi-disciplinary capacity.

•         The hospital discharge policy and model changed on the 1 September 2020 and since then the Home First Programme had been implemented across Dorset.

•         From the 1 September, the Government has funded care support for up to 6 weeks after discharge. This would continue up until 31 March 2021. However, it is expected that the Discharge to Assess model will continue beyond 31 March 2021 and any additional funding would sit within the Better Care Fund framework for the next financial year.

The operational lead for BCP Council on Home First explained to the Committee that:

•         Pressures continued to be extremely high on hospital staff.

•         The three areas that take the patient through discharge and recovery are the Hospital, the SPA (the Single Point of Access) and the One Team. This takes the patient being discharged through their journey of discharge, recovery and any further help required.

•         There are 5 Cluster teams working across Dorset, for example Bournemouth and Christchurch are Cluster 1 and Poole is Cluster 2. Within this model there are lead experts across health and social care and they look at the discharge process of all those leaving hospital and specifically where in their discharge journey enhancements can be made, for example mutual aid, mapping assessment needs, what data should be collected and learned from, how we can learn from individual, personal journeys and how best to align people to requisite services.

•         The situation is changing hourly. Critical care, making sure there is enough critical care capacity and staff, are extremely pressured and only a small percentage of patients are not COVID related.

•         In the Discharge to Assess model, there are 4 pathways – patients will go through one of the four pathways. Pathway 0 is for those who do not require any social care. This will account for 50% of discharges. Pathway 1 (45%) is where those discharged require support at home. Pathway 2 (4%) will need a rehabilitation or short-term care in a 24-hour bed-based setting. Pathway 3 (1%) will require ongoing 24-hour nursing care, often in a bedded setting. Long-term care is likely to be required for these individuals.

The  ...  view the full minutes text for item 110