The Care Quality Commission (CQC) has published its findings following a review of health and social care services in Northamptonshire.
The 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 carried out in April 2018, 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 there was a system-wide commitment to serving the people of Northamptonshire but that services had not always worked effectively together. It highlighted a number of areas where improvements are needed to ensure those responsible for providing health and social care services work better together.
Overall, CQC reviewers found:
- People in Northamptonshire had a varied and sometimes unsatisfactory experience of health and social care services.
- Hospital occupancy rates were high and both acute hospitals were failing to meet the national A&E target for time taken to be seen, assessed and treated. Some recent service design changes at Northampton General Hospital NHS Trust had led to improvements in performance, but it was too early to determine if these could be sustained.
- There was no systematic or joined-up approach across the county to use feedback from people, their families and carers, and public involvement in the development of strategy and services.
- Older people continued to stay longer in hospital and bed capacity issues meant some people were not cared for in the most appropriate place by the most appropriate staff.
- While there was a strategy for integrated, community, place-based care, arising from the Sustainability and Transformation Partnership (STP), this had not been developed into a single, coherent vision for Northamptonshire which could be clearly articulated by all staff.
- Aside from the Better Care Fund (BCF), there were limited examples of pooled budgets in place for the delivery of services across health and social care for older people.
- There were significant workforce pressures in a number of health and social care disciplines across services. This was having an impact on areas such as the number of unallocated social care cases and referrals.
This review makes a number of suggestions of areas where the local system should focus to secure improvement, including:
- Relationships between system leaders across organisations must improve, in particular between providers and commissioners, which was hampering progress towards integration.
- Integrated working between secondary and primary healthcare and social care services needs to be strengthened.
- The system needs to work together to develop and drive forward a shared strategic vision for the future.
- Improving information sharing across health and social care should be prioritised, as this has proved to be a barrier to integrated working.
- There needs to be a greater commissioning focus on developing preventative services.
- More evaluation and sharing of lessons learned across the whole health and social care system was needed. CQC did not see system-wide ownership of performance.
The publication of this review of health and social care services in Northamptonshire, follows the release of CQC's Beyond Barriers report earlier this month which brought together key findings and recommendations for change following the completion of 20 local authority area system reviews.