Agenda item

Purpose: To present the Better Care Fund annual report for 2022/23.

April Peberdy (Interim Service Director - Communities and Wellbeing) presented the Better Care Fund Annual Report 2022/23 and the Adult Social Care Discharge Fund Annual Report 2022/23 (Agenda Item 10).

In relation to the metric for the percentage of people discharged to their normal place of residence, Members asked if these cases were monitored to ensure that patients were not readmitted to hospital due to being discharged too soon. It was confirmed that the proportion of people who were still at home 91 days after discharge from hospital was a key metric.

Members highlighted the large number of acronyms used in paragraph 4.7 of the report. It was suggested that these should be explained in future reports.

Action: Councillor Jo Stewart to raise the use of acronyms with Maria Shepherd.

It was noted that residential admissions were a concern for the Council, since there was a considerable cost. Clarification was sought as to what was meant by a ‘trusted assessor’. It was explained that before patients were discharged from hospital, they were assessed to ensure that care was available to support them at home. It was recognised that there were challenges around who would fund what aspects of care and it was suggested that further work was required to ensure that funding issues were not affecting discharge decisions.

Action: April Peberdy to liaise with Maria Shepherd and provide further detail on the ‘trusted assessor’ role and funding to support hospital discharges.

It was stressed that it was important to try to keep people out of hospital in the first place, which would require a whole system approach, with improvements to housing, as well as investment in primary and community care. It was suggested that a patient’s discharge plans should be started on the day of their admission, with early consideration given to the suitability of their housing. To facilitate this, it was suggested that a housing sector representative could sit on each hospital board. It was highlighted that social workers were placed within hospitals to facilitate planning for when patients were discharged.

Officers highlighted the success of the ‘Be Well This Winter’ campaign where a system-wide approach had been adopted to support residents and keep them out of hospital. This included signposting residents to where and when they could get the right care. However, it was stressed that this was only part of the answer and it was suggested that there needed to be strong links between health, housing and planning. Historically, the NHS had been poor at linking to the housing sector, but the Health and Wellbeing Board was well-placed to have these conversations.

Members highlighted that the new Local Plan had a policy for 10% of new homes to be wheelchair accessible, but the Planning Inspector had questioned if there was evidence to support this need.

Although the Lifetimes Homes Standard had been around for some time, it was acknowledged that this was easier to implement in urban areas than in rural areas. It was suggested that local authorities had a role to play in encouraging people to think about their housing needs in the last 20 years of their lives to avoid issues with patients being unable to return home following a hospital admission.

Reassurance was provided that lots of work had been done within Berkshire West to improve planning for discharge from hospitals. However, it was acknowledged that more work was needed in relation to cases where patients were discharged too soon and had to be readmitted. It was stressed that discharge to care homes was a safe option, since patients had 24-hour care, so it should not be viewed negatively.

The Board was challenged to find ways to better celebrate successes, particularly around reablement, since patients had more faith in the system when they saw how others had been helped. It was suggested that the success of the vaccination centre at Newbury Racecourse had been instrumental in encouraging more people to volunteer and lessons could be learned from this.

Reassurance was provided that housing was a high priority for the Council. The Environmental Health Team was doing a lot of work in relation to private sector housing and a housing condition survey was being carried out. Also, the Housing Team offered facilities grants to residents. While there had been an increase in damp and mould over the winter, the Council was seeking to tackle this with private sector landlords.

Action: It was agreed to bring the housing stock condition survey back to a future meeting of the Health and Wellbeing Board.

RESOLVED to note the report.