To receive an update on the Government’s arrangements for funding and consider examples of work arising from Start funding.

Report of Executive Director, Adult Services, Housing & Public Health attached

Patricia Blackstock, Service Manager Hospital and Reablement introduced the report and with Amy Tipton, START,  gave a presentation providing an update on IBCF funding and schemes and explained how it had been utilised to provide extra capacity in Adult Social Care, reduce pressures on the NHS, and ensure that the local service care provider market is supported.    

Although the IBCF would be rolled forward into the next financial year there would be a shortfall of £700,000.  The Committee were informed of the governance process and impact assessment which had taken place to determine which schemes would be terminated.  This had resulted in the cessation of the Independent Care Home assessor contract and nine of the discharge to assess beds. 

Members were informed how the IBCF had provided additional funding to the START service and greatly enhanced the focus on reablement.  The presentation also provided some case studies of the journey of a number of individuals with complex reablement needs back towards full independence.

In response to questions from members it was confirmed that:

·         The two hour target for commencement of service was available in rural areas as there were pockets of staff living across Shropshire, an office based team in central Shrewsbury, and staff accessed an app on their mobile phones.

·         The impact of the reduction in discharge to assess beds would be monitored using the discharge audit tool used with partners to identify where there were any issues around patient discharge.  A task and finish group on discharge was ongoing and Healthwatch gathered feedback from patients.  System partners undertook weekly demand and capacity modelling to ensure the number of heath and social care beds in the system were monitored.  The utilisation of discharge to assess beds during October – December 2020 had been around 50 – 53%.

·         If a patient occupied a discharge to assess bed when the contract came to a close, they would be able to stay there as a spot purchase could be made. 

·         Shropshire worked with closely with Telford and Wrekin and a system approach helped align thinking around bed capacity. A demand and capacity group had helped with this and Shropshire had been able to support colleagues on a number of occasions when needed. 

Officers reiterated that patients remained at the centre of everything and the pandemic had helped to facilitate a move away from barriers and organisational restrictions and find quick, safe solutions to benefit patients.  Shropshire also worked with Powys which did have a similar reablement scheme, but without the local capacity of the START team.

Government guidance was that patients could not stay into hospital until they were able to go where they chose, the best destination to meet their needs were identified as quickly as possible and then work undertaken with families to identify long term places. 

Lynn Crawley, Healthwatch Shropshire reported that the interim findings of the Healthwatch discharge survey had been useful and the final report would be made available shortly.

The Chair thanked officers for the very useful report and presentation and for providing assurance that impact assessments had been carried out and been thorough and that there were processes in place to assess the impact of them.

The Committee agreed its support for lobbying of the government for consistency of funding for ICBF.