Agenda and minutes

There were no apologies.

There were no declarations.

The minutes of the meetings held on 18 February are attached and 24 February are to follow.

(TAKE IN MINUTES)

RESOLVED that the minutes of the Housing and Social Care Scrutiny Panel meetings held on 18 and 24 February 2014 were agreed as a correct record and signed by the chair.

The panel will hear from Mike Quinn, the Managing Director of Medicine for the Clinical Services Centre at QA Hospital and Marie Edwards, Senior Manager, Hospital & Health Services, Adult Social Care.

Mr Mike Quinn, the Managing Director of Medicine for the Clinical Services Centre at QA Hospital

Mr Mike Quinn explained that there are 105,000 discharges a year which are managed through the hospital. 80% of these discharges are classed as 'simple', with the remainder being categorised as 'complex'. There is a cohort in the middle which requires more focus and attention. An example of a simple discharge would be a patient who has an arranged procedure and is in hospital for a few hours for that procedure. An example of a complex discharge is when a patient is admitted following 'an event' and has more than likely come through the emergency department.

Prior to the pressure period before Christmas the Integrated Discharge Bureau ('IDB') used to meet twice a week, now it meets daily. Mr Quinn chairs these meetings which community partners from Hampshire and Portsmouth also attend. The IDB discuss the discharge and care package of the more complex cases, which tend to have a complicated discharge planner. Often social services recommend a referral whilst the patient is on the ward. It is at the IDB that the patients other needs often become identified. For example, whilst admitted a patient could become homeless. A delayed discharge is often non-health related and these cases are discussed daily at the IDB meetings. The bed stock needs to be utilised for 'acute' care. The hospital look to discharge a patient once the healthcare plan is complete and a safe discharge is ensured. The hospital does not want to leave any patient feeling vulnerable. Working with partners is key and the hospital's relationship with Portsmouth City council is very positive.

The following information was given in response to questions from members of the panel:

·         When a patient is in hospital, this offers a period of respite for the carer and it is often at this point that the carer feels they cannot cope. This is not recognised prior to the patient admission and so is not planned for. Families/carers feel that they cannot cope when the patient is discharged. The hospital would identify this as 'potentially complex' and would involve social services.

Mrs Marie Edwards gave an example of this where social services have recommended a patient be discharged to Grove House as an interim arrangement but the family are adamant that the best place for the patient is here in hospital. A whole care package is available for the patient at Grove House but the family are blocking the discharge. The acute care has finished and the family want the patient to go home but not via another route. The family have been advised that this is a step down opportunity to give the family more time to look at the next care step.

·         Families do not see that they are 'bed blocking' and feel that it is their right to say no to a discharge. It is about managing expectation, first at ward level by nurses and doctors, and then this  ...  view the full minutes text for item 18.

To be agreed by the panel.

It was agreed that the next meeting would be arranged in consultation with the chair and the panel members.