The Director of Adult Social Care, Manchester City Council and the Chief Operating Officer, Manchester Local Care Organisation

This paper updates the Health Scrutiny Committee on the work of health and social care staff in the Manchester Community Response services.

The Committee considered a report of the Director of Adult Social Care, Manchester City Council and the Chief Operating Officer, Manchester Local Care Organisation (MLCO) that provided an update on the work of health and social care staff in the Manchester Community Response (MCR) services.

Officers referred to the main points and themes within the report which included: -

·         Providing an introduction and background to the MCR;

·         Describing the overarching aims of the MCR;

·         Providing a description of the teams that comprised the MCR;

·         Describing what the MCR aimed to deliver;

·         The MCR and MLCO operating model;

·         Data on the number of avoided admissions to hospital as a result of the MCR; and

·         Case studies.

Some of the key points that arose from the Committee’s discussions were: -

·         Welcoming the introduction of integrated teams and the positive outcomes this had delivered for residents of Manchester,

·         Did teams experience challenges in regard to recruiting to post and stability of teams to deliver continuity of care;

·         The importance of recognising and responding to the wider determinants of health;

·         What were the challenges to patient discharge from hospital;

·         How many patients that were discharged from hospital readmitted;

·         Did the pressures experienced by Accident and Emergency Departments at hospitals influence the decision to discharge patients;

·         Were the financial savings achieved by avoiding unnecessary patient admissions to hospital calculated and reported; and

·         Was the Crisis Response service restricted to the number of hours they would engage with a patient.

In response to the above comments and questions officers informed the Committee that the wider determinants of health were understood and the establishment of multidisciplinary teams allowed for services to work together and make appropriate referrals to best meet the health needs of residents and avoid escalation and unnecessary hospital admission, as it was recognised that people had better outcomes if they could be supported to remain in their homes. The Chief Operating Officer, Manchester Local Care Organisation stated that the financial savings were calculated and reported.

In response to the question raised regarding barriers to discharging patients from hospital, the Director of Adult Social Care stated that they continued to work with acute settings to ensure that people were discharged, once medically optimised, to their home or other place of residence rather than remaining in hospital. The Chief Operating Officer, Manchester Local Care Organisationfurther stated that the pressures experienced at Accident and Emergency Departments did not influence the decision to discharge patients and free beds. He stated that alternative bed managements practices would be implemented, such as cancelling elective surgery. He further commented that people still attended Accident and Emergency Departments when other sources of assistance, such as General Practice or Pharmacy’s would be more appropriate and this resulted in additional pressures across Accident and Emergency Departments. In response to the specific question regarding the rates of re-admittance following discharge he advised that the analysis of this would be circulated following the meeting. 

In response the question asked regarding the number of hours a person would receive the Crisis Response service, the Manager, Manchester Community Response stated that they would support the person as long as was required. She further commented that whilst teams had experienced challenges in regard to recruitment to posts, this was a national issue. She described that teams worked together and shared care plans to ensure a continuity of care was maintained.

Decision

To note the report.