To receive Report No.34/2019 from Tamsin Hooton, Director lead for Community Services Redesign, West Leicestershire CCG.

Report No. 34/2019 was received from Tamsin Hooton, Director lead for Community Services Redesign, West Leicestershire CCG.

The purpose of the report was to provide the Panel with an overview of the Community Services Redesign project.

During discussion the following points were noted:

·         The scope of the work was core adult services and did not include children or mental health services.

·         Services had not been reviewed for a long time and the redesign project was an opportunity to look at joining up of services and supporting integrated care.

·         The new model would look to strike the right balance between the following three services; Community Nursing, Home First services (including crisis response and reablement) and community beds.

·         The review of current patient demand for the Rutland Memorial Hospital (RMH) did not warrant the re-opening of the moth balled ward although it needed to be reviewed whether over time this would change.

·         Demand for RMH beds was not based on the growing Rutland population but instead looked at the clinical needs of patients and their preferences, with most people wanting to stay at home.

·         Although there would always be a need for community beds at one time or another the capacity should not just be used because it was there and available, instead it should be about the right treatment and pathway for the individual.

·         The workforce was absolutely fundamental to getting the redesign right. Core nursing teams did not have enough capacity to extend services and there was a greater need for therapists who could work alongside social care partners as mobility was a key issue.

·         It was difficult to recruit therapists so there would be a need to grow the workforce by blending social care skills with some therapy skills.

·         Ms Hooton agreed with members that an acute hospital ward was not the place for dementia patients but also pointed out that wards at Oakham or Melton hospital were not designed as dementia facilities. Although this may be reviewed in the future, the current approach to reablement for those with dementia was that a care home environment may be more suitable.

·         Members had received complaints that residents had felt bullied into taking family members back home when they were not able to cope with their needs.

·         The new model would only work if carers felt fully supported and able to cope.

·         The second phase of the project would be making the investment case to the CGGs for more nurses as recruiting nurses was very challenging, particularly in LPT (Leicestershire Partnership Trust) where turnover rates were very high.

·         Pathway 3 services, (reablement beds that provide 24/7 bed-based care in a residential or nursing home) had been piloted in Rutland but Rutland had moved in to another phase and were successfully managing more people through reablement pathways and less people in care homes.

·         The project worked across a wide area which helped to create a much more integrated model.

·         Members felt that any fundamental changes in service delivery would have to run alongside existing services until proven otherwise people would fall through the cracks.

RESOLVED:

1.    The Panel NOTED the progress to date in redesigning community health services and the next stage of the work.