This report is one of 20 targeted local system reviews looking specifically at how older people move through the health and social care system, with a focus on how services work together. The reviews look at how hospitals, community health services, GP practices, care homes and homecare agencies work together to provide seamless care for people aged 65 and over living in a local area.
During the review CQC sought feedback from a range of people involved in shaping and leading the system, those responsible for directly delivering care, as well as people who use services, their families and carers
The review found that while there was a system-wide commitment to serve the people of Hampshire, services should be encouraged to work more effectively together. The review highlights a number of areas where improvements are needed.
Older people in Hampshire had inconsistent experiences of health and social care depending on where in the county they lived. While the organisations involved do have a health and wellbeing strategy and a vision for the whole of Hampshire, there was inconsistency in how the strategy was implemented and how services were delivered.
Partnerships across the Hampshire system were improving. Joint working between the clinical commissioning groups over the preceding year made Better Care Fund planning easier
The leadership and delivery of services for older people were organised into four local delivery systems (north and mid Hampshire, Portsmouth and south east Hampshire, south west Hampshire, and Frimley), which were associated with the four main acute hospital trusts.
People said they would like to see more signposting to services and more care planning before they needed care in a crisis. Some people also told reviewers that care was not seamless enough and that they would like to see a single point of access for information about services, although system leaders said that there already was a single point of access in place, referred to as ‘Connect to Support’
Older people told reviewers that there were a lot of services and support available in Hampshire but these worked separately across the different parts of the county and it was difficult to get information about what was available in your specific area.
Not all older people were found to be as involved in discussions and decisions about their care, support and treatment as they wanted to be. This was particularly noticeable with people who were funding their own care as they told reviewers that assessments were difficult to access.
CQC Chief Inspector for Adult Social Care, Andrea Sutcliffe, said:
“We found there are some excellent systems in place within Hampshire, with a consistently shared purpose and strategy for health and social care and a welcome commitment to improve how people move between different services.
“However, people‘s experience varies depending where in the county they live.
“There is considerable variation in how the larger hospitals respond when people need urgent admission at times of high demand, or when people are ready to come out of hospital, but still need continuing care. As a result older people often experience delays in receiving urgent care and when they are discharged home.
“We have presented our findings to the health and social care system leaders in Hampshire so they can continue to work together and focus their efforts to improve the delivery of joined up care for all people living in the county.”
This review identifies a number of potential areas for improvement including:
The system leaders must review all service provision to ensure the delivery of more equitable services across Hampshire.
The system must streamline discharge processes across Hampshire. This needs to include timely assessment and provision of equipment to reduce delayed discharges from hospitals.
The Health and Well-being Board should consider how to make the system better coordinated and form stronger links with the two Sustainability and Transformation Partnerships.
System leaders must develop a comprehensive health and social care workforce strategy for Hampshire in conjunction with the independent sector, and working in partnership with financial, housing and transport strategies.
The, health and social care system, must work with the independent sector, and nursing home, care home and domiciliary care providers to improve relationships and develop services that meet demand across Hampshire.
A comprehensive communications strategy should be developed to ensure health and social care staff understand each other’s roles and responsibilities and all agencies are aware of the range of services available across Hampshire.