The Board will receive a verbal update from Jack Edge of SWL ICS.
Minutes:
The Health and Wellbeing Board received a verbal update from the Head of Primary and Community Care – London South, Jack Edge in relation to the discharge fund and winter pressures.
In summary, the Board heard that:
- In November 2022, there was an initial fund of £500 million pounds to support the discharge into social care, which was divided into two pots: 60% within the health sector and 40% to the local authorities. The distribution of the ICB share and the Adult Social Care discharge fund to local areas, saw Croydon with £2.687 million pounds which was split into £1.5 million pounds from the NHS and £1.16 million pounds from the local authority.
- The funding was to be used on activities that reduced flow pressure on hospitals by enabling discharge to appropriate settings. This was not to be used to prevent admissions. Funding was also to be streamed into the Better Care fund.
- Croydon provided twenty-six schemes. The projects put forward would be monitored fortnightly to address the spending. The service was on track on their second return having completed and signed off their first return in spending.
- There was also funding for eleven stepdown beds which had been purchased.
- Discharges had been increased into pathway discharges by thirty per week, i.e. path one: would see the patient return to their original place of residence with a care package.
- Support for seventeen housing spots was provided to mental health patients.
- Recruitment across all roles were taking place to provide care capacity, inside and outside of hospitals though roles were filled with existing staff.
- Additional support such as drivers, IT support and equipment had also been used from the funding.
- The GP rapid response provision had increased, also additional equipment to ensure all packages within the community through the rapid response had increased.
- A flow hub had been set up to facilitate discharge and prevent discharge at the front door in hospitals. This had been successful.
- Additional mental health treatment had also been established with support for discharge at home.
- Working with local authority and South West London (SWL) to best spend the £200 million pounds that was allocated within the NHS to facilitate the discharges, with the guidance around increasing bed capacity and activities contributed to supporting the beds, before 31st March 2023.
The Board welcomed the update from officers.
In response to queries raised by the Board, Jack Edge and Annette McPartland clarified the following:
- In relation to the work of the projects and feedback from the first return completed, the Board heard that the first report took a lot of time away from implementing the projects and assessments within the community, the hospitals were now providing daily reports on discharging. This had shown great impact to the health and commissioning leads. The first report highlighted no queries, though some areas received queries on specific projects to understand impact. There were no queries raised with the Croydon specific projects as information provided was thorough and succinct. Through the learning, from a mental health perspective, staff were able to move patients quickly, though there were still delays with those ready for discharge and the home provision was to be revised. The provision commissioned for this short period of time,
- In relation to the short-term money and beds, the Board heard that the preference of Home First was to be the ultimate pathways such as Pathway Zero and Pathway One; and the service would be reviewing the spending to assist the local needs and to not merely increase the bed base. The spending of the money would be assessed for purpose within Croydon. Further, the Board heard that with the voluntary sector there was a big project around Pathway Zero that helped the innovation fund through South West London.
- In relation to what support there was for families where patients returned home causing huge challenges on the family, and those patients with no recourse to public funds, the Board heard that the network for support was included within the package as family were deemed the primary carers, though this was different in most cases.
The Chair thanks all officers for the update.