The Board considered a report of the Director of Health and Care Integration which provided assurance regarding the national quarterly requirements for the Better Care Fund. A copy of the report marked ‘Agenda Item 10’ is filed with these minutes.
With regard to delayed transfers of care (DTOC), it was noted that there was still scope for improvements in performance to be made, both by individual organisations and collectively. Performance at UHL had remained fairly constant but there had been a deterioration in performance both at community hospitals and in mental health in-patient wards, where the lower numbers of patient beds meant that any delay had a significant adverse impact on performance. Work undertaken this year would focus specifically on these areas.
The local assessment of the eight High Impact Changes that could be made to improve DTOC had been refreshed and improvements in relation to these would be reported as part of the Better Care Fund assurance process. Through the refresh, areas for focus and potential investment had been identified. Patient choice continued to be one of the causes of DTOC: actions identified to address this included ensuring patients received the right information about discharge when admitted to hospital and at every stage during their journey. It would also be important to ensure that appropriate services, including housing support, were in place in the community to support discharge.
The DTOC position was further complicated by the different reporting requirements across the NHS, Social Care and the Better Care Fund. It was not possible to create a single trajectory to support delivery of the three different metrics. However, the LLR DTOC metrics group was developing an integrated dashboard to help with this.
NHS England welcomed the proposal in the Better Care Fund Plan to set a more challenging DTOC target and observed that the Better Care Fund schemes had made a significant difference to delays in the discharge of older people. The focus now needed to shift to working age adults and mental health inpatients. It was also noted that the approach and data collected by Leicestershire for the Better Care Fund had been found to be useful on a regional and national level.
(a) That the contents of the report be noted;
(b) To note that the quarter four 2016/17 BCF return was approved by representatives on the Integration Executive on 23 May, and submitted to NHS England on 31 May