A national Care Quality Commission (CQC) review has been carried out in Stoke-on-Trent to look at how well older people and specifically those over 65 can move through the health and social care system.
Health and care leaders have pledged to work together to improve services for Stoke-on-Trent residents with their first task to develop an action plan to drive through areas for improvement.
As part of the review, which took place between 4 and 8 September, the work of public sector organisations including Stoke-on-Trent Clinical Commissioning Group (CCG), Stoke-on-Trent City Council, University Hospitals of North Midlands NHS Trust (UHNM), and Staffordshire and Stoke-on-Trent Partnership NHS Trust* was examined. It focused on how services including GPs, care homes, hospitals, health commissioners and the local authority work together.
Representatives from Healthwatch Stoke-on-Trent, as well as voluntary and community sector services were also interviewed by the CQC, alongside service users.
The review has highlighted a number of areas worthy of praise within Stoke-on-Trent, including:
- A positive change in the relationships between all partners across the system, and a willingness to work collaboratively in order to improve services.
- Positive progress relating to the Better Care Fund (BCF).
- Joint commissioning arrangements between the CCG and Stoke-on-Trent City Council for learning disability, dementia, mental health and carers’ services – elements of which could be replicated in other services to make improvements.
- Pooled budgets from health and social care commissioners providing arrangements for the help people receive in the community after they leave hospital, which are having a positive outcome for patients.
- The new cross sector delivery plans for discharge to assess (D2A), which are being introduced and should reduce delayed transfer of care.
- A number of opportunities for service users, families and carers to share their views, which helped to inform strategic planning across the health and social care system.
- The national award winning Meir Partnership Care Hub that brings together health and social care services to deliver more effective services to those living within Meir in Stoke-on-Trent.
Nine areas for improvement** were also highlighted by the CQC. Leaders across health and social care have agreed to prioritise these working together to deliver the improvements for the people of Stoke-on-Trent.
Cllr Ann James, Cabinet Member for Health and Social Care and Vice Chair of the Stoke-on-Trent Health and Wellbeing Board, said: “It is absolutely right that we put people at the centre of health and care services and sign up to one vision and strategic plan for the city. We welcome this review, which will see us collectively accelerate improvements to make sure that our own planning and processes align within the overall system to deliver the right care in the right way at the right time for the people we serve.”
Diane Lea, Chair of the Stoke-on-Trent Health and Wellbeing Board, said
“This is about building relationships and working in a more joined up and effective way across the whole health and care system in the city. The Health and Wellbeing Board is 100% committed to robustly holding leaders to account to deliver these improvements for the people of Stoke-on-Trent.”
Marcus Warnes, Accountable Officer for the Staffordshire Clinical Commissioning Groups said, “We fully accept the challenges we face in collectively meeting the health and social care needs of the people of Stoke-on-Trent. The area is not without its own particular issues and it is important that we work closely across the system to join up our commissioning decisions to provide the right care in the right place for local people.”
Paula Clark, UHNM Chief Executive, said: “We welcome the CQC report and the recommendations that we need a more system wide strategic approach to meet the needs of over 65s. We can’t continue to allow the most vulnerable in our society, the elderly, to suffer long waits in A&E and to remain stranded in hospital beds because of a lack of community services. This is going to be a very difficult winter and all health and social care organisations are working together to ensure the elderly are treated with the care they deserve. In the longer-term we look forward to working with partners to develop coordinated care to stop the older generation being admitted into a hospital bed and subsequently losing their independence, when they could be better treated in the community.”
Neil Carr, Chief Executive of Staffordshire and Stoke on Trent NHS Partnership Trust (SSOTP) said: “There is willingness between leaders across the care and health system in Stoke-on-Trent to work collaboratively going forward, which this report recognises.
“SSOTP is very much committed to working as effective partners within the local system and I believe that the strategy and shared purpose is now in place so that we can begin to really improve and enhance care for the residents in Stoke-on-Trent, as well as supporting patients discharged from the Royal Stoke University Hospital.”
Caroline Donovan, Chief Executive, North Staffordshire Combined Healthcare NHS Trust said: “It is only by rapidly implementing a new vision of integrated, patient-centred care that the significant improvements to urgent care and lengthening delays in treatment can be remedied. We are proud to be helping implement, through the North Staffordshire and Stoke-on-Trent Alliance Board, the new vision that recognises the crucial role of GPs, primary care and the voluntary sector working alongside health and social care moving to integrated services across North Staffordshire and Stoke-on-Trent.”
Sir Neil McKay, Independent Chair of Director of Together We’re Better, the sustainability and transformation partnership (STP) delivering transformation of health and care for the citizens of Staffordshire and Stoke-on-Trent, said:
“The report underlines the need for effective partnership working, which is what Together We’re Better is seeking to achieve. It recognises that relationships are improving and we must learn the lessons contained within it to shape our ongoing collaboration. We have an opportunity to show that we can deliver something special in Stoke-on-Trent and we are all determined to improve health and care services for the people of the city.”
* North Staffordshire Combined Healthcare NHS Trust was involved where services touched on those over 65 with mental health or dementia issues.
- There must be better and effective communication between leaders of the system.
- There must be effective joint strategic planning based on the needs of the local population with clear shared and owned outcomes.
- Attention should be given to long-term strategic planning across the system within an agreed joint performance framework.
- System leaders should ensure effective delivery of their integrated strategic plans.
- Strategic commissioning should be aligned to the agreed strategic plans and must include primary care
- System leaders should ensure an integrated approach to market development which should include the monitoring of quality in the care and voluntary sectors.
- An effective system of integrated assessment and reviews of the needs of people using services should be introduced urgently.
- There should be integrated delivery plans which include resources and workforce.
- The trusted assessor scheme should be implemented as soon as possible.