ON MONDAY, November 11th, the Welsh Government launched a 50-day challenge to help more people safely return home from hospital and to ease winter pressures on Wales’s health and care system.
Health boards and local authorities will collaborate to use a 10-point action plan to support more people who have experienced long delays in hospital in returning home.
The challenge is designed to ensure the NHS and local councils work together to share and learn from best practices, improve system performance, and ensure the availability of the right support to help people stay well or recover at home or in the community.
All health boards and local authorities have accepted the 50-day Integrated Care Winter Challenge, which will run until the end of the year, set by ministers.
The challenge will also specifically target the people who have been waiting the longest to leave hospital.
The NHS in Wales is experiencing persistently high levels of pathways of care delays (delayed discharges), which negatively impact people’s long-term health and the “flow” through the wider health and care system.
Cabinet Secretary for Health and Social Care Jeremy Miles said: “It’s essential we support our health and care services over the winter so they can continue looking after the sickest and most vulnerable people.
“There is no place like home for people to recover from an illness or injury once they are ready to leave hospital. Equally, there is a wide range of support services available in our communities that can help prevent people needing to go to hospital in the first place, helping them to stay well at home.
“The 50-Day Integrated Care Winter Challenge and the 10-point action plan will strengthen our health and social care system so that we can help more people to stay well at home and get more people home from hospital when they are ready to leave.
“I’m really pleased the NHS and local authorities have constructively embraced this challenge and have prepared to take immediate collective action to respond.”
Minister for Children and Social Care Dawn Bowden added: “Community-based care can improve outcomes, especially for older people and those with complex needs. We know people recover better at home than in a hospital, where unnecessary stays can affect their physical and mental well-being.
“There are many good examples where health and social care teams are working closely together to ensure people can be supported to stay well at home or move smoothly from hospital into the community where the right support is available to them.
“This 50-day challenge is about promoting best practice and making sure it is available and consistently applied across Wales.”
The 10-point action plan of best practice interventions includes steps to remove the blockages in the health and care system so people can be discharged home promptly.
This includes improving hospital discharge procedures, planning for discharge from the point of admission, ensuring proportionate and effective seven-day working to enable weekend discharges, undertaking more assessments in the community, and providing community rehabilitation and reablement to help people recover fully.
Community health and social care services play a pivotal role in supporting people’s well-being in the community. They assess what help people need, including access to rehabilitation, home adaptations or personal care in the community.
The 50-Day challenge is a key element of the Welsh Government’s winter resilience plans. The £146m Regional Integration Fund, the £11.95m Further Faster funds, and the £5m allied health professional funding are helping to build community capacity in the system.
The Health Secretary and the Minister recently met teams at the Integrated Discharge Service at the University Hospital of Wales in Cardiff to learn more about their approach to getting people home safely and discuss best practices.
Diane Walker, Head of Integrated Discharge Service at Cardiff and Vale University Health Board, said: “We know patients should leave hospital as soon as they’re ready to do so. When a patient spends longer than necessary in hospital, they are at a higher risk of losing their independence and deteriorating further.
“Recently, an elderly frail male was admitted to hospital due to an acute illness and increased needs. Following hospital-based assessments, it was agreed that his care would need to be provided by a care home.
“The process to find a suitable care home involved adult social care, providing details about the patient to the homes and waiting for a response. However, it proved difficult to find a home that could meet his needs. This resulted in his hospital discharge being delayed and an increased risk of deconditioning, catching a hospital-acquired infection and risk of a fall. To prevent this, health and social care teams worked together to provide details about the patient, and a care home place was secured.
“As a result of this successful joint approach, it was agreed that all ‘pen picture’ details about patients will be completed by health and social care teams in the future.”
Welsh Conservative Shadow Health Minister Sam Rowlands MS said: “My concern with Labour’s latest initiative is that it’s all aspiration and arbitrary targets with no additional financial backing or plan to increase social care capacity.
“The Welsh Conservatives would pass on every penny received for health on the Welsh NHS to integrate it more appropriately with social care, properly financing councils with a new funding formula to deliver the service and to enact a substantial workforce plan to hire more doctors and nurses as opposed to Labour’s plan to create more jobs for politicians.”
Welsh Conservative Shadow Minister for Social Care, Dr Altaf Hussain MS, added: “Both the Darzi and annual Healthcare Inspectorate’s reports were clear that discharge delays into the community and social care were a massive factor in Wales’ excessive waiting lists which have increased for seven consecutive record-breaking months.
“We need to value our care workers more if we are to free up and expand capacity in the social care sector to tackle the long Labour-run Welsh NHS waits we continue to see.”
The Director of the Welsh NHS Confederation, Darren Hughes, said: “The capacity to support people in communities and the ability to discharge medically fit patients from hospital remains a huge challenge for all health boards and social care partners due to the immense system pressures. In some hospitals, 20% of beds are occupied by patients waiting to leave.
“The NHS is fully committed to working in partnership with local authorities to ensure that people get the care and support they need in communities across Wales.
“The fragility of the social care sector is one of the biggest challenges facing the health and wellbeing of our population. Our social care services are facing immense pressures, including some local councils and care providers stating they are on the brink of bankruptcy.
“Social care plays a crucial role in supporting people remain independent for longer, preventing hospital admissions and supporting faster, safer discharges home. The sector plays a critical role in enabling the NHS to deliver safe and timely care, with delayed transfers of care out of hospital having a huge impact on patient flow through the whole healthcare system.
“Record levels of demand on health and care services are not going anywhere and will continue to be a huge challenge with existing resources. Unless the broader challenges of demand and capacity across the whole health and care system are addressed, a 50-day challenge and action plan won’t be enough to achieve a sustainable health and care system in the long term.”
