A report published by the Care Quality Commission (CQC) shows significant improvement in the health social care system for older people living in Stoke-on-Trent.
CQC carried out the review to follow up on an earlier report, published in September 2017, which looked specifically at how older people move through the health and social care system, focusing on how all health and social care services work together to provide seamless care for people aged 65 and over.
At that time CQC found older people living in Stoke-on-Trent sometimes had poor experiences of care and did not always have access to the right care, in the right place at the right time. This was due to the health and social care system - led by Stoke-on-Trent City Council and Stoke-on-Trent Clinical Commissioning Group – not working in a joined up way to meet people’s needs.
On CQC’s return to assess how the system was working together, reviewers found significant improvements had been made in Stoke-on-Trent.
Professor Steve Field, chief inspector of primary medical services and integrated care, says: "It was encouraging to see the changes that had taken place since our initial review of how services work together in Stoke-on-Trent. Previously we found that some older people in Stoke-on-Trent had a poor experience of care, because local health and social care services had not worked together effectively.
“In 2017 we found that organisations and individuals designing and delivering services in Stoke-on-Trent were not working to an agreed, shared vision and there was a lack of whole system strategic planning and commissioning with little collaboration, at that time.
“But, on our recent return, we found things were much improved for people in the city. We found that the culture had shifted and system leaders, including elected members, shared the same vision and were supportive of each other. There was greater transparency between leaders meaning they could address issues together. This had helped them to make progress and improve people’s experience of care.
“The quality of care in independent social care and how those commissioning care worked with providers of care had improved. There were no care homes, nursing homes or domiciliary care services rated as 'inadequate' and the percentage of nursing homes rated as 'good' had increased from 26 to 42 per cent.
"There had been some good joint strategic work to develop plans for the coming winter of 2018/19 and patient flow through the Royal Stoke Hospital had improved considerably. System leaders were confident that they would be able to maintain this throughout the winter to cope with the additional pressures that would arise.
“System leaders should be commended on the progress they have made to build relationships and enable more effective communication across the system. While there are still some improvements to be made, CQC’s review found a system that was working together more effectively and improving care for people across Stoke-on-Trent.”
The review makes a number of suggestions of areas for the local system to make further improvements:
• The voluntary, community and social enterprise (VCSE) sector needed to be better involved to support services towards an approach to take a more preventative approach towards the health and social care needs of the community. VCSE representatives, system leaders and managers acknowledged that this needed to be improved and the VCSE sector needed to be better involved in health and social care in the area.
• Development of the workforce was happening in Staffordshire, linked to the Staffordshire Sustainability and Transformation Plan (STP), but some strategies to recruit staff had not been successful and were being repeated. Therefore improvement was needed to ensure more staff with the right skills were employed.
• The Local System Review identified that integration across health and social care needed to be a priority.Key to the success of this would be improved information and data sharing across health and social care organisations.At the time of our review, there was a continued risk that people would have to tell their story many times and that professionals would not always be able to share the right information at the right time.
• While the development of end of life pathway processes continues, system leaders should ensure that people who are in the last days of their lives are receiving the care they need in their preferred setting.
