The pressures faced by hospitals this winter have been labelled ‘unprecedented’ with a higher number of admissions to Accident and Emergency departments and challenges around discharging patients quickly enough to free up sufficient beds.
The number of delayed discharges due to the need to organise social care are ‘very low’ for Chichester’s St Richards Hospital and Worthing Hospital, but the figures are higher for both East Surrey Hospital in Redhill and Haywards Heath’s Princess Royal Hospital.
There was a ‘clear correlation’ between delayed discharges at these two hospitals and significant market pressures on care support at home and residential placements in their catchment areas, according to a report discussed by West Sussex Health and Adult Social Care Committee (HASC) last Wednesday (March 8).
Peter Griffiths (Con, Hurstpierpoint and Bolney) said they were ‘rushing from one crisis to another crisis’ and what he wanted to see was a clear plan of what the system would look like in six months to help solve the current problems.
Mark Howell, director of adults’ operations at West Sussex County Council, explained that social work teams had made a ‘massive effort’ over the last few months.
James Walsh (LDem, Littlehampton East), vice-chairman of the committee, acknowledged that the county council was performing well compared to its peers, but statistics showed that bed-blocking had doubled in the past two years.
He suggested problems securing appropriate care from the private market for people who fall outside the council’s eligibility criteria was because carers are ‘underpaid, undervalued and often less skilled than they should be’ and struggled to secure affordable housing in Sussex.
Dr Walsh added: “I’m disappointed by the report because it refers to the problems but does not come up with any solutions to solve the problems.”
Peter Evans (Con, East Preston and Ferring) argued this could be addressed by far more convalescent care sitting between acute hospitals and homes, co-funded by the NHS and local councils.
Marjorie Cobby House in Selsey was listed as a current example, while officers said they were looking at reablement beds in the north of the county.
David Sheldon (Ind, Horsham Tanbridge and Broadbridge Heath) asked irrespective of definitions how many West Sussex residents were currently in hospital who are able to be at home.
Marie Dodd, chief operating officer at Coastal West Sussex Clinical Commissioning Group, suggested terms such as ‘medically fit for discharge’ were unhelpful, and that there were problems getting patients through the system.
She suggested high numbers of people may not need an acute bed, but one in a community setting.
Meanwhile they also had to understand what was driving the increase in patients turning up at A&E.
This was especially a problem between 7pm and 2am with a high percentage being working age adults who ‘probably are not going to the appropriate place’.
Amanda Jupp (Con, Billingshurst) felt there was ‘something wrong’ with patients turning up at hospitals with minor ailments that could be addressed by medication and over the counter advice at pharmacies.
However charging patients for attending A&E or doctors’ surgeries would be seen as ‘rather draconian’.
Christine Field (Con, Lindfield and High Weald), cabinet member for wellbeing, explained how they were working with partner organisations on a public information campaign urging people to think twice about going to A&E if there were other solutions.
Avril Wilson, executive director for care, wellbeing, and education, said that working age people in particular were using A&E services in a ‘particularly inappropriate way which eats resources’.
But she added: “The system itself is no longer fit for purpose given the challenges it faces.”
While comments were read out from Western Sussex Hospitals NHS Foundation Trust’s chief operating officer, no representatives from the other acute trusts serving West Sussex attended the meeting.
Brenda Smith (Lab, Langley Green and West Green) said: “How seriously do they view the HASC? I’m appalled they have not bothered to send anybody.”
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