Consideration of a report containing exempt information.
Written report by Joy Hollister
Minutes:
The Group Director of Children’s, Adults and Housing introduced the exempt draft report (previously circulated to all Board members) for consideration and comment.
The Integrated Care Commission, which is committed to improving the services offered to the local population, had proposed the concept of a Joint Assessment and Discharge Service which would be responsible for the safe and timely discharge of patients from acute settings, (primarily Queens Hospital and King George’s Hospital), and would serve all three boroughs. It was hoped that the service would be implemented by April 2014.
Teams would be placed in wards and they would be able to discharge to any borough thus improving the patient experience as well as increasing hospital efficiency and effectiveness. Barking and Dagenham had led on the project with the engagement of NELFT and BHRUT.
Coalition members agreed the Design Principles at the workshop in April 2013 which were clarified by the Project Steering Group and translated into the following aims:
· To facilitate safe return home through collaborative working;
· To provide the integrated health and social care support required to discharge patients with social and/or complex medical needs;
· To identify end of life patients who wish to be looked after at home and ensure that they receive expedited discharge with the right health and social care support;
· To minimise delays arising from problems with inter-agency liaison;
· To focus decision making with the service user at the centre of processes;
· To analyse trends e.g. frequent attenders, borough trends, reduction in bed use, increase in community care packages.
The potential benefits identified:
· Improved patient experience - supporting patients to be discharged to the most appropriate location first time;
· Increase in numbers of people returning home and reducing the number of people going into residential and nursing home placements;
· Single patient centred screening and assessment process;
· Decline in complaints
· Reducing length of stay and delays in discharge;
· Potential release of capacity based on cross cover and shared resources across health and social care;
· Reduction in number of voided section 2s and increase in the section 2 to section 5 conversion rate;
· System talking with one voice;
· Change in culture and reduction in organisational boundaries;
· Cross service cohesion and joint decision making;
It was noted that the draft report would also be considered by Barking & Dagenham and Redbridge Health and Wellbeing Boards before being presented to the appropriate decision makers.
The Board Members noted the report and commented as follows:
a. There was no mention of enablement within the “Discharge and Returning home”.
b. It was noted that a manual information system would operate before the move to a shared electronic system, and Board members requested that a Risk Assessment and Audit should be carried out on the whole procedure.
c. There were currently five other authorities/organisations involved in the proposed JAD and there was a need to build trust between the organisations.
d. The Board requested further reassurance around costing and suggested that more work was required in this area, and also on population structures as these varied from borough to borough.
e. Concerns were raised about patients that may be forgotten in outlying wards and that there would need to be a tracking system built into procedures.
In summary, the Board were supportive of the proposals although it was a significant investment and would cost more. The key to success in the project was likely to be in assembling the right teams and good benchmarking.
The Director thanked the Board for their feedback which would be reported back to the Steering Group.