Agenda item

Improving the Urgent Care System in Leicester, Leicestershire and Rutland: Focus on Hospital Discharge


The Committee considered a report of the Director of Adults and Communities and the Director of Health and Care Integration which provided an analysis of hospital discharge performance and assurance of actions being taken to improve performance, in the context of the changes underway across Leicester, Leicestershire and Rutland to improve the urgent care system.  A copy of the report marked ‘Agenda Item 9’ is filed with these minutes.


Arising from discussion the following points were raised:-


(i)              With regard to the additional arrangements in place to support discharge, it was noted that the extension to the role of the Primary Care Co-ordinators was funded through the Better Care Fund.  It was intended to extend this resource further and consideration was currently being given to the most effective way of doing this.


(ii)             Housing support to discharge was currently being provided at the Bradgate Unit.  This was funded through the Better Care Fund.  Work was currently being undertaken to identify patients at the Leicester Royal Infirmary who would benefit from housing support and when it would be most appropriate to make this intervention.  It was suggested that any intelligence regarding housing generated by this project be fed back to the District Council lead officers for Housing.


(iii)            The social care support to discharge was largely funded through the County Council’s mainstream budget.  Some areas of additional work were funded through the Better Care Fund.


(iv)           There had been issues with the capacity of the Domiciliary Care Market to enable service users to have choice and also to get packages of care in place quickly to support discharge.  The reasons for this included use of reablement services, timeliness of reviews of care packages and the commissioning proves.  There was now some evidence that domiciliary care was being used and managed more effectively by the County Council.


(v)            Leicestershire had received a grant from the Department of Health to help address current pressures on acute hospitals caused by delayed discharges to social care.  The funding had to be spent by the end of the financial year.  The Urgent Care Board would consider how to allocate the funding at its next meeting.


(vi)           With regard to Leicestershire’s position relative to the rest of the Country, there was no doubt that, despite the work undertaken so far, there was a lot of progress still to be made.  It would be important to track the impact of all interventions to assess their effectiveness.  It was felt that the best way for progress to be made was for the health and care system to focus on a small number of agreed metrics that would have the most impact.


(vii)          It was confirmed that there was pressure on Continuing Health Care Funding.  It was also noted that the Adult Social Care budget in the County Council was currently forecast to overspend, although the department continued to commission all the care that was required.  It was noted that there was an opportunity for efficiencies to be made through joint working in relation to Continuing Health Care, both strategically from a commissioning perspective and operationally.   This was currently being scoped between the County Council and Clinical Commissioning Groups.




(a)  That the current performance in relation to delayed discharges be noted;


(b)  That further assurance from partner agencies about the actions in progress to improve hospital discharge and the impact these will have be sought and any concerns arising from this be referred to the Urgent Care Board;


(c)  That the Integration Executive and Urgent Care be asked to consider how the Leicester, Leicestershire and Rutland health and care system can achieve a truly integrated approach to hospital discharge in the medium term;


(d)  That the Integration Executive be asked to consider any further detailed work on matters specific to Leicestershire at its meeting on 27th January;


(e)  That the Integration Executive be asked to consider if any adjustments are needed within the Better Care Fund Plan in 2015/16 in support of the urgent care system at its meeting on 27th January.


Supporting documents: