Agenda item

7.1

The Committee received a report which gave a summary of the city’s approach to winter planning for the City and operational delivery of continuing healthcare over the coming months.

7.2

Present for this item were Alun Windle (Chief Nurse, Sheffield Clinical Commissioning Group), Dani Hydes (Head of Continuing Health Care for Adults and Children) and Sara Storey (Interim Director of Adult Health and Social Care Services).

7.3

Sara Storey introduced the paper and said that there was a large amount of work being carried on throughout the city to make sure we have the right set off priorities and principles to enable us to understand what needs to be done in acknowledging what is likely to be a tricky winter.

7.4

Alun Windle gave a summary on the key areas for the development and delivery of Continuing Health Care (CHC) Framework, which had been suspended in March, in response to the Covid pandemic.  By working with the Acute Hospital Discharge Hub, the CHC team had managed new referrals where a health need was present, until they could be assessed under the framework and these patients were classed as “NHS Covid Funded”. In planning for the reinstatement of the framework, he outlined three specific key work streams, firstly, Covid Backlog, being individuals assessed and Covid funded during March to August.  Secondly, the Discharge Support Fund, this being all new referrals under the framework with effect from 1^st September, whereby the assessment has to be carried out within six weeks of discharge and thirdly, the CHC Team was working to address outstanding assessments pre-Covid.

7.5

Members asked a number of questions, and responses were given as follows:-

·                There are some significant continuing health needs resulting from the effects of Covid.  The majority of these, while living with continued health needs, can be picked up through universal services, although some will require additional health funding.  Colleagues familiar with the framework with rehabilitation, where there could be lung rehabilitation or long-term organ failure due to covid is another issue.  Also, another aspect of this are the psychological and mental health effects of the virus.  The CCG is picking up additional resource and focusing on providing additional mental health services.  Support has also been provided to those working in the health care sector dealing with Covid, who have developed mental health issues.

·                The discharge hubs that were in place post covid have continued although it is difficult to resource it across the span of health and social care.  There is a different legislation in relation to discharge that has been put in place alongside CHC processes, and resource has been put in to assess individual needs.  It was considered that “home is best” for recovery, however the focus is that we resource on what we can do in the best way that we can so that patients can return to their own home.

·                With regard to carers and family support, where people were not allowed to mix households, the response to this during the Covid pandemic was that family members moved in to create a bubble.  It was important to make sure we get the assessment right. At the beginning of the discharge we have to take into account the complexity of the different tiers being introduced.

·                Practitioners do their best to understand what support people have got available before being discharged and staff in hospital talk to family members so that they are fully aware of what is available.  In terms of extra support to assist people, we have emergency response that can help should family support fail for whatever reason, so we can put support in place to avoid someone having to go into a care home, thus enabling them to remain in their own home.  The Home First Team was always available offering practical help, as its not always about direct care.  We A number of people were identified who required more sustained support and that support was provided directly through in-house services, from the pool of staff recruited throughout the Covid pandemic as extra casual workers and a contract has been offered to one of those casual workers.

·                There was a view that those people who were struggling might be overlooked, but people have been reaching out to those in need and more “good neighbours” have been supporting people who might normally not have reached out and helped.  The Council has been working with other providers to make sure the needs of those who were in need of assistance, have received what was required.  We need to make sure that we have robust systems in place to support carers, to identify their needs, and therefore we speak to carers regularly to find out their needs and help them.

·                Verbal feedback so far on health and social care has been really good, although very small numbers have responded, no negative feedback has been received. 

·                Winter planning is about acknowledging that there are additional demands on health and social care, due to the fact that people tend to become ill during the winter months, with flu or norovirus. We need robust business continuity in case of bad weather, to manage the unexpected, and Covid could put extra demand on services with potentially more people being admitted into hospital. We are aware that a lot of people have accessed elective care over the lockdown period and this has created backlogs for the health service and this too could create extra demands on services. 

·                Officers have had to change the way they work. Things are slower because the correct use of PPE takes time and has to be changed regularly, and due to the fact that patients are not allowed into waiting rooms or a discharge lounge, again it slows things down.  Staff delivering these services may become ill themselves or have had to self-isolate, so therefore there has been increases the number of staff shortages.

·                No additional funding has been provided to help with health and social care to deal with the extra demands and pressures.  At a meeting with the Minister for Health and Social Care, the question was asked of what additional funding would be available to local authorities to help with winter pressures but there was no answer given. 

7.6

RESOLVED: That the Committee:-

(a)      thanks Alun Windle, Dani Hydes and Sara Storey for their contribution to the meeting; and

(b)      notes the contents of the report and the responses to the questions.