Agenda item

Purpose: To inform the Board on progress with this piece of work.

Tandra Foster introduced the report to Members of the Board, which sought their endorsement of the Frail Elderly Pathway as a design that informed service arrangements. Tandra Forster reminded Members that there was an accompanying presentation, which had been circulated and included a higher level of detail on the work. 

Work on the Frail Elderly Pathway started in 2012 prior to the Better Care Fund (BCF). The Frail Elderly Care Pathway came out of a number of stakeholder workshops facilitated by the King’s Fund, which enabled the whole system to develop a local model. The model was centred around the needs of Sam (a typical patient with a variety of health and social care needs), as described in Sam’s story, rather than by which services were in place. The end point was to have something that was easier to navigate around and to develop a pathway and direct resources where they would have most impact.

Tandra Foster reported that more work was required on the financial modelling aspect. At this stage the report set out an overview of the piece of work and was requesting that the Board accept the principles of the Frail Elderly Pathway work.

Fiona Slevin-Brown reported that she and her colleague Stuart Rowbotham were leading on the piece of work and it had been recommended that a more complex piece of work was required. The King’s Fund work had been excellent however, it was difficult to roll out on a larger scale and therefore the wider partnership would be expected to help with this. Financial impacts would need to be considered and the Health and Wellbeing Board would have a key role in overseeing the work.

Tandra Forster reminded the Board that there was more detail in the presentation that had been circulated. Adrian Barker had read the presentation and felt that it was more about ‘doing to’ rather that ‘doing with’. Fiona Slevin-Brown stated that work had been very service focused however, they were now looking at how people ‘aged well’. This focused largely on empowering individuals to ensure they received the right care.

Rachael Wardell added a point of caution in that there was already an established framework and therefore there would be a significant demand on workforces to act. These workforces were already used to working in a particular way. It would be challenging for some as they relied on the existing framework and would need to let go of their professional authority.

Dr Barbara Barrie reported that there would be large challenges around how the frail elderly were indentified. She queried how aligned the work would be with Primary Care’s two percent service. Dr Barrie also highlighted the ‘Living Well’ project taking place in North and West Reading, which was working particularly well.

Dr Bal Bahia stated that the Board had seen the Frail Elderly Pathway work develop over the past 18 months. Thought needed to be given to how a changing culture could be supported and the Board needed to have a key role in challenging where the project was going.

Fiona Slevin-Brown clarified that although the project was called ‘Frail Elderly’, it was about people growing older and the empowerment aspect of prevention. It did not reflect ‘Frail Elderly’ in the clinical term.

RESOLVED that the Health and Wellbeing Board endorsed the Frail Elderly Pathway work taking place.