First CQC local system review published in Halton in Cheshire


The Care Quality Commission has published its findings following a local system review of Halton in Cheshire.

This report is the first of 20 targeted reviews of local authority areas looking specifically at how people move through the health and social care system – with a focus on how services work together. 

The reviews look at how hospitals, community health services, GP practices, care homes and homecare agencies work together to provide seamless care for older  people living in a local area.

The review found that there was a strong commitment and a shared vision across the local authority and the clinical commissioning group (CCG) to serve the people of Halton well.

There was a positive approach to maintaining people’s health and wellbeing in their own homes, with services designed for older people to keep them socially included, active and able to manage their long term conditions.  There was good support for carers including those supporting people living with dementia.

Work was underway to provide older people admitted to hospital with better experiences by reducing avoidable hospital admissions and delayed transfers of care.

Following a joint analysis of need new services had recently been introduced to avoid hospital admissions including rapid seven-day re-ablement service and a rapid clinical assessment team.  Transformation projects for Care Homes and Domiciliary Care were underway so that people’s individual needs could be met in a timely way.

As a result the numbers of delayed transfers of care were reducing and performance had improved.

The challenge for the system was to continue to implement its local plans at pace to embed the recent changes and to sustain the social care workforce.

The review found that the continuous improvement of patient flow through acute services and the provision of timely and sufficient community based services were crucial for the system to sustain improvements in performance and meet the challenges of increased demand as winter approaches. 

 Professor Steve Field, Chief Inspector of Primary Care Services, said:

“Our review of Halton’s services – and how they work together – has demonstrated that a joint approach and a shared focus can improve people’s experiences of health and social care. 

“We have found some great examples of good leadership, producing shared approaches and local agreements that support people living in Halton get access to the services and support that meet their individual needs.

“We were pleased to find that some new services and initiatives were having a positive impact and that delayed transfers of care were reducing.   Performance has improved and is now  better than the national averages.

“However, there is more that can be done.  It is important that the flow of patients through the local hospitals continues to improve and that more community- based services are provided so that people continue to receive high quality services when they need them.

“Since Halton is served by two hospitals in neighbouring boroughs, there is potential for the system to fragment.   It is vital therefore that Halton council plays a full part in the success of the Sustainability and Transformation Partnership and the emergent Accountable Care System to ensure future progress.

“Clearly the will to work together is evident: the local authority and the CCG have developed a very healthy relationship, and the local acute trusts are involved in planning for the future”


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