Agenda item

The Chairman updated Members on the following:

The first formal meeting of the Buckinghamshire, Oxfordshire and Berkshire West Joint Health Overview and Scrutiny Committee took place on Wednesday 25^th January, 2023. The Chairman reported that she had been elected as the Chairman, and Cllr J Hanna from Oxfordshire County Council had been elected as the Vice-Chairman for the ensuing two years. The draft Integrated Care Partnership strategy had been discussed and a formal response had been submitted to the ICP, outlining the key concerns and suggestions made by JHOSC Members.

Three questions had been submitted to the Cabinet Member for Health and Wellbeing, Cllr Angela Macpherson in advance of the meeting.  These questions are detailed below along with the written responses received. 

Funding – What has the impact of the recent Government announcement, in relation to the use of care home beds to support Hospital Discharge, had on ASC and the development of the new model for Hospital Discharge?

With respect to the recent announcement of funding for hospital discharge, this additional government funding is being used to fund additional social work capacity for the social work assessments and working with the person and their family members to support them through the process. Additional discharge beds within care homes are also being sourced alongside provision for patients waiting to be discharged who are unable to return home because they are homeless or their house is in a state of disrepair.

A Health and Care and Integration Programme is already in place which we briefed HASC on at the last committee. This is developing a new discharge model for Buckinghamshire. At the moment, programme capacity has been diverted to manage current winter pressures (drawing on new national funding streams) - this has slowed the development of our new model for hospital discharge. It was agreed in January that the pace on this would be slower across the Winter period and pick up again afterwards with external support.

Capacity – During December and January, how many people have been discharged to Olympic Lodge and other facilities across the county?  How does this compare to the same period last year?  What has been done differently this time to improve the discharge process at times of significant winter pressure.

By mid-January, Olympic Lodge had been operating for 14 weeks. As at the week ending 15th January, (week 14), Olympic Lodge had admitted 219 patients, compared to 150 in week 14 in 2022.

The key difference to last year is that the focus of the Olympic Lodge facility is patients who are most likely to be able to respond to therapeutic intervention and regain much or all of their former independence.   People with highly complex needs such as dementia are being discharged directly into a care setting which is able to support their specialist complex needs – this may be at home with home care or into a care home.

Workforce – At the budget scrutiny session, you mentioned that there are 19 agency staff within the discharge team. Can you give us a sense of how long the agency staff have been working in this area – longest serving staff member to the newest agency staff member.  What is the total number of ASC staff working within the integrated team, what is the current vacancy rate and what are the plans to reduce agency staff in this area?

As of 7th Feb, the number of agency staff in the discharge service has risen to 21. These are funded by the NHS through the winter pressures discharge grant funding. Some of these staff have previously been working in other parts of the ASC service before moving into the discharge area.  The longest serving agency worker has been working with us (but not always in the discharge service) since August 2019 and the most recent started in in the last couple of weeks.

There are 19 permanent posts in the ASC discharge service with, (as of 7th Feb) 5 vacancies – a vacancy rate of 26%.

In simple terms, whilst demand continues in hospital discharge and the cost of agency staff is met by external funding, we are not planning to reduce agency use in this area.