Agenda item

(indicative timing: 11:45am – 12:15pm)

Jenny Dalloway, Lead Commissioner for Mental Health, Learning Disabilities and Children for Herefordshire and Worcestershire Clinical Commissioning Group provided a brief introduction of progress on the service model for the Hospital at Home Service, following the earlier discussion with the HOSC in September 2021.The Service for older adults with functional mental health illness had evolved from a temporary service change during the COVID pandemic, where the focus was for people to remain at home.

The Agenda report set out the findings of the initial consultation to make the change permanent, the proposals for which had been fully supported by the System. It was explained that some differing views had come through, although of note these were from stakeholders asking ‘what would happen if’ questions, and not from those using the Service. The original consultation had occurred during the pandemic, therefore a further consultation was planned to be really clear on the impact for patients and carers, and it was hoped that the further communication would address any concerns.

The Chairman invited discussion and the following main points were made:

·         HOSC members praised the positive outcomes of the Hospital at Home Service and the initiative in taking forward the changes.

·         When asked for examples of a patient journey through the Service, Jayne Westwood, Service Manager for Older Adult Mental Health at Herefordshire and Worcestershire Health and Care Trust (HWHCT) explained that the two main aspects of the Service were around enabling a patient in a hospital ward to go home or to avoid someone at home needing to go into hospital. Typically, the duration of care was two to four weeks, after which care would continue with community care teams.

·         When asked about the benefits and challenges of the changes, the representatives advised that the main benefit was avoiding stay on a hospital ward, which were also more difficult for families to visit and most patients and their families wanted them to stay at home. Hospital at Home staff were multi-disciplinary and able to visit up to four times a day, a level of care which was rare in hospital and very effective. So far it had not been necessary to use any external beds outside of the county.

·         Sue Harris, HWHCT Director of Strategy and Partnerships pointed out that home treatment for mental health had been around for a long time, therefore being able to do this for older adults with mental health illness was really great.

·         There had been no feedback to suggest that public transport access had been an issue and information was provided about hospital transport. Previous experience indicated that patients had not always chosen the nearest facility for hospital stays.

·         It was clarified that the hours for the Service were 8am – 8.30pm, with a 24 hour/7 day a week crisis team although it was very rare to require this.

·         It was explained that the Service was able to provide more specialised needs-led service, whereas the all age provision lacked expertese with the co-morbidity of older age.

·         When asked whether the pandemic could have influenced people’s responses to the consultation, the representatives explained that this was a factor in carrying out a further exercise.

·         A patient being assessed for the Service was usually already known to the System and whoever was involved in their care would also be involved.

·         It was clarified that there were around 18-20 referrals to the Service per month, with some fluctuation.

·         Martin Gallagher, the Healthwatch Worcestershire (HWW) representative present explained that HWW had been aware of and involved in discussions about the changes from the start and whilst there was still a lot of learning to take place as the Service evolved, the benefits to patients were clear. No negative feedback at all had been received through the many networks HWW was involved with and generally it was seen as a major enhancement and an approach which it was hoped could be extended to other services.

The Chairman thanked everyone for their attendance and acknowledged the approach as the way forward, with a request for a further update in 12 months’ time.