Agenda item

The FutureCare Programme is a Dorset-wide programme aimed at delivering better health and care outcomes for residents and reducing the time people spend in hospital waiting to be discharged, or in hospital if support can be provided at home.

Significant challenges still exist in increasing flow and reducing the no criteria average length of stay (NCTR ALOS) for residents in the East of the County.  However, overall, the Futurecare Programme is on track to deliver its anticipated benefits, and robust plans are in place to address challenges in the East.

For BCP Council positive long-term benefits are now beginning to be delivered with positive operational and cumulative benefits delivered in November as home-based intermediate care effectiveness and throughput begins to increase.

The Director of Adult Social Care and the Programme Director - FutureCare Programme presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'A' to these Minutes in the Minute Book.

The purpose of the Report was to update the Health and Wellbeing Board on progress with the FutureCare Programme.  The FutureCare Programme was a Dorset-wide programme aimed at delivering better health and care outcomes for residents and in particular reducing the time people spend in hospital waiting to be discharged, or in hospital if support could be provided at home.

Significant challenges still exist in increasing flow and reducing the No Criteria to Reside (NCTR) and the average length of stay (ALoS) for residents in the East of the County. However, overall, the Futurecare Programme was on track to deliver its anticipated benefits, and robust plans were in place to address challenges.

For BCP Council positive long-term benefits were now beginning to be delivered with positive operational and cumulative benefits delivered in November as home-based intermediate care effectiveness and throughput increased.

A mid-programme review had been undertaken and this identified that significant benefits were being delivered for residents:

·       80 more people per week, or more than 4000 per year were being referred to Same Day Emergency Services (SDEC) as an alternative to hospital admission;

·       The number of referrals into long term residential and nursing care placements from acute hospitals had reduced by 20% and from intermediate care beds by 30% since the beginning of the programme;

·       Each week at least 40 people, or more than 2000 per year, were returning home from an intermediate care bed in Dorset at least one week sooner than at the beginning of the programme (ALoS reducing from 38.2 days at the beginning of the programme to 33.9 days at the beginning of December);

·       At Dorset County Hospital, patients waiting for a supported discharge were waiting 1.5 days less to receive a package of care than at the beginning of the programme.

In addition to focusing on delivering improvements in the East of the county, work was now underway to prepare a business case to support the reduction of intermediate care beds.  Advice and engagement remained ongoing with NHSE regarding the best approach to changes in this area, and a proposal for the process and configuration of beds would be presented to BCP Council, NHS Dorset and other partner organisations in the New Year.

Overall, at the beginning of October the programme was on track against its operational benefits trajectory, delivering a projected £12.87m of annual operational benefits, against a target of £12.54m.  

The Board discussed the report, including:

• The significant efforts and infrastructure from programme team, system partners, and strategic partner were highlighted and praised.
• It was noted that the programme would help to focus on embedding outcomes into business as usual for sustainability, including home-based intermediate care.
• Consideration needed to be given to benchmarking opportunities and integration with community and primary care initiatives.
• Emphasis was placed on ensuring internal organisational infrastructure, particularly around digital and informatics, to maintain progress post programme.
• In response to a query regarding any negative impact the difficult winter had had on the programmes trajectory, the Board was advised that the situation had been closely monitored and that the FutureCare programme had supported data analysis and identification of hotspots, complementing business as usual while driving forward sustainable transformation.
• The Board was also advised that additional capacity was commissioned by health partners and adult social care to tackle the winter pressures which demonstrated great partnership working and alongside the programme created positive and tangible outcomes.
• In response to a query regarding the differences shown between the outcomes for different hospitals, the Board was advised that the success at Dorset County Hospital (DCH) was attributed to earlier implementation on a smaller scale, with plans to replicate at University Hospitals Dorset (UHD).  The contextual differences between hospitals were highlighted, including factors such as population, bed numbers, and new hospital models.
• The Chair noted the BBC report on NHS discharge challenges and agreed strong local partnership working was a positive indicator for future outcomes.

RESOLVED that the Board:

1. Recognises the progress that the programme continues to make in respect of improved outcomes for people and the delivery of financial benefits to the Dorset Integrated Care System
2. Notes that more work is required to reduce the average length of time people spend in hospital waiting for a care package.

Voting: Nem. Con.