Despite hospitals planning for the considerable challenges they face over winter, the demand for beds continues to peak in Derby. Year on year accident and emergency (A&E) waiting room admissions increase, this is estimated to be about an extra 70 patients a week.
NHS England says the additional pressure comes from those who, for the most part, are admitted with respiratory conditions brought on by cold weather and viruses. Many of these tend to be older or vulnerable people who require a bed space until they are well enough to go home. If people stay longer than necessary this leads to ‘congestive hospital failure’ which means that new patients cannot be admitted because the hospital is full.
As people are living longer, integrated health care is fundamental in maintaining the health of this city’s population – a healthy community means less strain on stretched public sector resources.
We are not just seeking a quick fix to reduce emergency admissions and speed up discharges but are seeking to improve patients’ quality of life, restore independence – so people do not have to fear that a trip to the hospital may result in admission to a residential or nursing home. We seek to deliver a care package that meets needs which address age-related conditions such as heart disease, dementia, diabetes and obesity. We also ask GPs to undertake health checks to make sure patients keep on top of their health so unnecessary worrying trips to A&E can be avoided.
Derby City Council and its health partners have come together to provide an integrated service that aims to ease some of the pressure that hospitals face during these dark cold months. Our newly formed Hospital to Home (H2H) team – of four social workers and six community care workers – has a key role in reducing hospital delayed discharges and increasing the flow of people back to their own homes. Based at Royal Derby Hospital and working closely with London Road Hospital, H2H provides a single point of access for all adult social care referrals from the hospital.
The team has been set up to work with the ‘discharge to assess model’, which recognises that people recover and function best in their own homes. Home visits are carried out to assess people’s needs and provide a care package in partnership with community nursing care. The teams are able to provide small aids and adaptions in people’s homes quickly, but also commission stair lifts and level access showers where needed
I am pleased to say that integrated working and the provision of community support has had a positive influence on the community. There are now fewer people going to residential or nursing care homes in Derby than before. Figures have been declining since 2008. However, without further investment from Government these figures will steadily increase again and we want to prevent that at all costs.
The Derby and Derbyshire health and social care system is under significant pressure, not just in terms of demand but also financially – estimated to be in the region of £300 million over the next five years. The increasing challenge we face is keeping older people healthy at home and out of the hospital, which means creating and maintaining strong links between all public services, but particularly with the NHS. However, integration and joined-up working will not bridge the financial gap on its own.
I call upon the Government to address the chronic underfunding of health and social care urgently. It is unacceptable that people are not getting the treatment and care they need in a timely, compassionate and dignified manner. This undermines the fundamental principles on which the Labour party founded the NHS in 1948.
Published: Friday 20th January 2017