Agenda item

11:15

Contact Officer – Alan Sinclair, Assistant Head of Adult Social Care (Older People and Physical Disability Services)

A report to update Scrutiny Committee on the performance, remedial action and strategy in respect of delayed transfers of care (AS7). The report provides an update to the report presented on 26 October 2010. The minute of the meeting on 26 October 2010 is attached as an annex.

The Director for Social & Community Services will present the report and Mr Sinclair and the Cabinet Member for Adult Services will also be present to answer any questions raised. 

The report was presented and attention was drawn to two graphs contained in the report which showed that delayed transfers of care had been reduced.  It was also pointed out that delayed transfers of care fall into three key groups, those due to people waiting for:

• Health care or a community hospital placement
• Social care, care home or carer package
• Both health and social care support

John Jackson explained that less than half of delays are due to social care delays and that these have been brought down from 100 to the current figure of just under 40 and the plan is to reduce these to under 20.  But also pointed out, due to the complexity of the issue, this will never be completely eradicated.

The following questions were posed by the Chairman and answers were provided by Steve Thomas [Answers in italics]:

a.   Can it be confirmed and made clear that only those who "pass" the eligibility criteria are counted.   Do people become eligible during or immediately after, their hospital treatment while still in the acute hospital.

Answer: No, the delayed transfers of care figures include those who may not have a need for onward care as it is not known at this point and also includes people who are self-funding.

b.   From when, after the doctors pronounce a person as ready for discharge, does the clock start ticking to be included as a DTOC .

Answer:  To be counted as a delay a person must be:

(i)                 medically fit to leave

(ii)               clinically stable with an agreed place to go

(iii)             safe to discharge

c.   If a patient is moved to a "holding " ward in the acute hospital, does this show as a DTOC.

Answer:  There are no holding wards in acute hospitals in Oxfordshire.

d.   Do we have a record showing how long the patients recorded as DTOC actually remain in the acute hospital.

Answer:  We do not record this information at present although could collect it in the future.

e.   Are we sure that the reporting and recording system in Oxfordshire conforms to the practices in other UK Counties.

Answer:  It is difficult to say whether the reporting and recording system are the same in Oxfordshire as elsewhere because the guidance is both convoluted and lacks detail.  There are anomalies between areas, for example delays for community hospitals are only counted for areas that have them so the figure describes the configuration of services in your area.  It is perhaps more useful to look at trends in your area over time.

f.    Do other Authorities accept a patient's refusal to move out of the acute hospital

Answer:  There are very few options in this situation save for going down a legal path which is not the policy in Oxfordshire.

There followed a discussion about the appropriate approach and focus for efforts to reduce delays.  It was AGREED that progress on the medium term strategy set out at paragraph 13 of the report should be reported back at a future Scrutiny committee meeting.