The Care Quality Commission has published its findings following a local system review of Hartlepool. This report is one 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 local health and social care partners, including Hartlepool Borough Council and NHS Hartlepool and Stockton-on-Tees Clinical Commissioning Group, to serve the people of Hartlepool well. Health and social care professionals were highly dedicated to supporting people using services, their family and carers.
There was effective involvement of people using services, their families and carers. People were engaged in developing and improving health and social care, including through the Hartlepool Matters report, which identified the needs of local people and which, along with the joint strategic needs assessment, local vision, the health and wellbeing strategy and the BCF plan; resulted in a cohesive vision and implementation plan for the area.
Local priorities were focussed on keeping people well in their normal place of residence by providing them with preventive services and support, and there was a shared understanding across system partners of the challenges that each organisation faced and a willingness to work together with a solution-driven approach without compromising their own organisational responsibilities
Some of the key findings of the review were:
- Most older people living in Hartlepool received health and social care services in a timely way, although some concerns were expressed in respect of access to GP services.
- QCQ found a multidisciplinary, integrated approach to delivering a number of services including the single point of access, which improved people’s experiences by reducing the multiple points of entry in to the system and enabled people to access timely care and support.
- Local people benefitted from access to direct payments for their health and social care needs, with a greater proportion of people in the area using direct payments than the national average or in comparable areas. This was positive for people, enabling them to have control and involvement in their care planning.
- People living with dementia were being identified at an early stage and they, their families and carers were well supported.
- There was an active voluntary, community and social enterprise (VCSE) that played a positive role in supporting older people to remain at home to be socially included, with a range of community support groups that provided advice, support and guidance.
- The local authority had worked well with local providers to encourage the development of new care facilities and improve availability; recently there had been a significant increase in care home bed numbers that was supporting improved patient flow and helping to reduce delayed transfers of care.
- Frontline interagency and multidisciplinary teams were supporting people to move through the system smoothly and seamlessly; there was good support placed at ‘front of house’ in A&E to help to prevent avoidable admissions. Once people were admitted to hospital their journey was tracked via the patient flow coordinators and the integrated discharge team. This was having a positive impact and preventing people staying hospital longer than necessary.
- System leaders had developed winter plans covering the resilience of the system to support increased demand and frontline staff were aware of the plans.
- Feedback from frontline staff was, in the main, very positive, although they identified issues about workforce; particularly about the recruitment and retention of nurses in nursing homes and paramedics.
Professor Steve Field, Chief Inspector of Primary Care Services, said:
“Our review of Hartlepool’s services – and how they work together – has found some positive examples of shared approaches and initiatives that support people in Hartlepool to have timely access to services that meet their needs in a person-centred way. The joint approach for people living with dementia is a good example of this.
“I am pleased to see that there have been proactive attempts to stabilise and improve capacity in the care market, although work is still required from system leaders to address the shortfall in care home provision for specialist beds for mental healthcare and end of life care.
“It is important that system leaders continue to develop their integrated approach and improve their working relationships beyond local partners and across the wider STP footprint to enhance system-wide alignment.”