Agenda item

Presentation by Paula Swindale, Head of Commissioning and Strategy, NHS Tees Valley Clinical Commissioning Group; Joss Harbron, Assistant Director Adult Social Care, Darlington Borough Council; and Dr. Ewan Tevendale, Consultant, County Durham and Darlington NHS Foundation Trust.

Members of this Scrutiny Committee received a presentation to update Members on the Frailty Pathway System from Paula Swindale, Head of Commissioning and Strategy, NHS Tees Valley Clinical Commissioning Group, Joss Harbron, Assistant Director Adult Social Care, and Dr Ewan Tevendale, Consultant, County Durham and Darlington NHS Foundation Trust.

The presentation outlined the four Strategic Plans that had been in place since 2014 namely the Health and Well Being Strategies Priorities for Older People; the Better Care Fund; South Integrated Care Partnership Frailty Pathway; and Ageing Well.

Frailty priorities were outlined including strategic outcomes to optimise the quality of care for those people admitted to hospital and the transformation ambitions to discharge people as close to home and ensure they had the right support to avoid re-admission.

The definition of frailty was outlined and the ways in which the Responsive Integrated Assessment Care Team (RIACT) supported people presenting with frailty was highlighted in the presentation, including the wider Social Care support to ensure interventions happen at an early stage to avoid admission to hospital; and outlined the Acute Frailty developments at Darlington Memorial Hospital (DMH) and the acute services offered,  seven days a week, with the support of the private sector, Rapid Response, Care Homes and domiciliary provision.  It was also highlighted that enhanced care in Care Homes was also a priority with more direct interventions to promote independence within Care Homes.

The presentation provided a set of data (from 100 patients) to show the flow and length stay outcomes for patients with frailty at DMH and feedback from patients, and it was also reported that over 2000 referrals had been seen by the Acute Frailty Team from April 2021 to October 2021; detailed how people were being supported at discharge, including the Trusted Assessment relationships between health and social care within Darlington; and outlined the future plans which included within the Ageing Well Strategy,  refreshing the Health and Well Being Board priorities; and highlighted some of the challenges faced including the workforce and Covid impact on delivery, recruitment and retention.

Members’ questions from the presentation were in relation to the outcomes between care within the home compared to being in a Care Home; how frailty had been affected by the lack of face-to-face at General Practitioners; how the Team link in with other preventative services within the home, ie. home insulation/fuel poverty; monitoring of re-admissions to hospital; changes to the service due to the Covid Pandemic; and issues arising from delays in the Ambulance Service.

RESOLVED – That Paula Swindale, Dr Tevendale and Joss Harbron be thanked for their interesting and informative presentation.