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WAQ79447 (e) Tabled on 13/02/2020

In relation to his response to OAQ55071, what assessment has the Minister made of implementing a 24/7 social care discharge service so that patients are discharged sooner to the right settings and more space is made available in Emergency Departments?

Answered by Minister for Health and Social Services Answered on 25/02/2020

In 2019 we announced a £30million winter budget on 1 October, earlier than ever before, to prevent unnecessary admissions of people to hospital and to enhance capacity and resilience.  Of this £30m, £17m was allocated to Regional Partnership Boards to promote integrated, regional planning.  In January I announced an extra £10m to support partners working together to improve the flow of patients through the hospital system and out into the community.

In addition, through the £100m Transformation Fund, regional partners are working together to free up spaces in hospital settings and ensure patients are safely discharged as soon as possible. 

In Cardiff & Vale the Get Me Home Preventative Service is a new single access point within the hospital which uses ‘What Matters’ conversations to provide holistic tailored support that meets the well-being needs of the individual, providing preventative interventions and supporting independent living.  This project is now operating across 9 wards and over 1,100 patients have been supported through the service.  As a result, 555 estimated hospital bed days have been avoided. Equipment Delivery timescales have reduced from 7 days to same day and the Telecare provision timescale has reduced from 15 days to 1 day. 

Get Me Home Plus, another Cardiff & Vale project, is working with patients who are more impaired and require a more intense package of re-ablement and homecare support. This service takes the person’s recovery to their usual home surroundings, reducing further deconditioning and the risk of hospital-acquired infections.  At the end of January 2020, 57 discharges had been achieved using this service in Cardiff and a further 44 in the Vale.

The Gwent Regional Partnership Board has introduced Home First, a 24/7 hospital discharge scheme, with the aim of getting people home faster, with the right package of care in place. The focus is on short stay wards to support those who do not require admission. Home First is working on behalf of the five Local Authorities within the region in supporting discharge from hospital. The model enables one team to collaborate with health and provide a single point of contact in supporting discharge regardless of an individual’s residence. Over 1,000 patients have been assessed by HomeFirst, and on average 25 people per week are being discharged through the service.

There are also a number of Integrated Care Fund projects that support hospital discharge being taken forward in all regions across Wales.

Cwm Taf Morgannwg has introduced Health and Social Care Discharge Coordinators, a partnership arrangement involving Cwm Taf Health Board and Rhondda Cynon Taf and Merthyr County Borough Councils. This project provides hospital discharge arrangements at four hospital sites across the region aimed at improving health and social care communication. In 2018-19 over 600 discharges were facilitated.

In addition the staywell@home service that operates across Cwm Taf supports timely release of patients from hospital through the integration of health and social care services on presentation at A&E. In 2018-19, some 455 hospital discharges were facilitated by the triage team and 584 community based services were commissioned to support discharge.

Cardiff and Vale’s Extended Reablement Service is provision of a range of services to support discharge from hospital and enhance patient flow through the use of Community Resource Teams. In 2018-19, some 778 people were supported.

The Integrated Discharge Service for Cardiff and Vale involves the provision of additional social workers and a Third Sector Discharge Coordinator to provide enhanced discharge support arrangements. Through this service 640 people were supported in 2018-19.

The Western Bay Optimal Model is a community based service for people aged 65 years old and over, aimed at getting them home from hospital as soon as possible by having support arrangements in place in their own home so that they can stay independent and avoid readmission. In 2018-19 1,778 discharges were facilitated, and over 39,000 bed days saved (which equates to a saving of £5.3million).

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