By Donna Hall and Natalie Abraham,

This winter will be probably the most challenging ever for health and social care organisations, for their staff and for patients and their families.

In the last year, there has been a significant increase in the number of people who remain in hospital when they should be back at home with the right social care support, or in another care setting that better meets their needs.

The challenges of ‘no reason to reside’

Often referred to by NHS Trusts as patients with ‘no reason to reside’ or ‘delayed discharges’,  there are an increasing number of people staying beyond the conclusion of their medical treatment. This in turn puts patients at risk of reduced mobility, leading to loss of muscle mass and increases the possibility of a hospital-acquired infection. It also adds to wait times in Emergency Departments, as beds are occupied, resulting in problems of patient flow through acute trusts.

As well as an increase in the demographic older age profile, Government cuts to council funding have impacted massively on adult social care over the last 13 years. This has meant a tightening of eligibility criteria to access support, both at home and in specialist facilities. A lack of resources to build sufficient specialist supported housing for people who require additional support to live independently has also contributed to the crisis, as well as low pay in the adult social care sector, leading to a shortage of frontline carers.

Increased spending on community services to reduce non-elective admissions

Integrated care systems (ICSs) are faced with a 30% savings pressure, in addition to an increased demand from a less healthy and well, post-pandemic population. We are all very adept by now at describing the problem in our board and system meetings, but what can practically be done by ICSs, councils, community services, primary care and acute hospital trusts?

In an ideal world, ICSs would have the freedom to move additional resources into community services and social care, to support a more community-driven infrastructure of supported housing, as well as more accessible and flexible social and primary care. A recent report by Carnall Farrar revealed integrated care systems spending more on community services had 15% lower non-elective admission rates and 10% lower ambulance conveyance rates.

Working together to ensure a home-first approach

Integrated discharge teams working together as part of neighbourhood place-based teams means that social workers, occupational therapists, community health visitors, housing officers and the community and voluntary sector can work together as a team around the person and their family – putting in place bespoke solutions to ensure a home-first approach.

C.Co’s Maximising Proportionate Care programme supports local authorities, ICSs and the NHS to maximise their care resources, through conducting robust risk assessments and utilising more dynamic moving and handling techniques and equipment.

C.Co also has a programme of work around the Better Care Fund and how systems can utilise this fund to optimise and maximise its resources.

Most recently, C.Co has developed an offer for local authorities around the upcoming CQC inspections. C.Co’s independent CQC Inspection Readiness Healthcheck enables local authorities to determine how well they are performing in the areas that the CQC will inspect against.

Get in touch with C.Co today to discuss how we can help you deliver optimally in the current challenging environments we face, and how we can support you when it comes to your strategic, tactical and operational planning.