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Agenda item

Better Care Plan

To receive an update on the delivery of the Better Care Plan for Wiltshire and emerging plans for 2018/19.

Minutes:

Consideration was given to an update report from the Portfolio Delivery Manager – Integration, Wiltshire Council and Clinical Commissioning Group on the Better Care Funding Programme, which included an update on the Section 75 agreement for 2018/19. This had been presented to the Health and Wellbeing Board on 29 March 2018.

 

It was pointed out that:-

 

·         Overall non-elective admissions for Wiltshire were around 10.7% higher

than last year, but this was driven in the main by changes in coding at a

couple of trusts and some transfer of responsibility from Specialised to

CCG Commissioning, without these changes the increase would be

around 4.8%. Avoidable emergency admissions were down 1% and

admissions from non-LD (Learning Disability) care homes were down nearly 3% on the same period last.

 

·         New permanent admissions to care homes remained at historically low

levels due in part to availability of care homes.

 

·         The percentage of people at home 91 days post hospital discharge

had reduced, data quality issues were causing issues with regards to

the production of accurate performance information which was being

managed to ensure reliable information for 2018-19.

 

·         The number of Delayed Transfers of Care days continued to fall and

performance was improving on that seen earlier in the year, however our

position remained above the planned trajectory.

 

·         Urgent care at home continued to see more referrals, with 72 in

January, which was close to the target of 80 people, however the % of

admissions avoided was lower at 75%

 

·         Help to live at home activity increased in January for new cases, the

total was 47 compared to 28 in December

 

·         Urgent Care at home activity had increased 36% on the same period

last year which aligned to the delayed days that had reported 6.4%

lower than the same period last year, but remained well above trajectory

for October 2017. This was a positive move as the Better Care Fund

workstreams embedded; however further work was required to enable the system to be sustainable in 2018 and into 2019.

 

·         Intermediate Care Bed admissions were at a level broadly similar to the

same period last year but discharges were 2% higher. Domiciliary Care

activity for new clients was 4.5% higher than the same period last year

and ongoing support was 7.2% higher suggesting the new models of

care to support Home First was starting to change the system model

from residential to normal residential of choice.

 

During discussion, Members enquired as to how reliable was the data information provided for 2017/18; it was explained that the figures for 2015/16 were somewhat overstated but new systems were now in place which resulted in the provision of more accurate data and also the easier and more efficient discharge of patients from hospital with a new recording system.

 

The Committee was reminded that the Better Care Plan Task Group had previously recommended to this Committee at its meeting on 10 January 2018 that the monitoring of the Better Care Plan be monitored, as a topic for scrutiny,   against the following five national performance areas:-

 

·         Admissions to residential and nursing care.

·         Success of reablement and rehabilitation.

·         Delayed transfers of care.

·         Avoidable emergency admissions.

·         Patient and service user experience.

 

After further discussion,

 

Resolved

 

(1)          To note the contents of the update report.

 

(2)          To request an update from officers on the Better Care Plan Task Group’s recommendations, including confirmation that “User experience” was being monitored.

   

Supporting documents: