Agenda item

The Committee considered a report that provided a position statement on Integration of Health & Social Care in Carmarthenshire and specifically,

an update with regards to specific priorities which were set out to deliver on a community care system for Carmarthenshire.

Following a presentation to Scrutiny Committee at its June 2023 meeting, members agreed to support the development of a plan building on a range of initiatives. This plan was to address the complex and multiple needs of the patients rather than the capabilities of the current provider landscape. It would consider both immediate impacts that changes could make as well as setting out a model that would meet medium and long-term demand of the frail and elderly.

Members noted that work in Integration between Health and Social Care had been focussed on delivery on the frontline of seamless services to the public. Progress on wider strategic integration had not been what was envisaged last year. Significant financial pressures, changes at Chief Executive level and a reorganisation within Health made further progress in strategically integrating the Local Authority and the Health Board unlikely in the short to medium term.

The Chair welcomed to the meeting from Hywel Dda UHB Dr Sioned Richards (GP Lead, Carmarthenshire Intermediate Care) and Indeg Jameson (Acute Response Team Physiotherapist) who provided the Committee with an update and presentation on the integrated work that was being undertaken within Carmarthenshire’s Eastgate Hub. The Committee was advised that the multi-disciplinary team had a shared vision and goal to support people in their homes and to prevent admissions. Referrals were received from hospitals, community, and GPs. The integrated way of working resulted in patients receiving the most appropriate level of care.

A number of questions were raised to which officers responded. The main matters were as follows:

• In response to a query regarding the model and the challenges of linking with GPs, it was advised that the model was working well however minor adjustments were needed such as an increase in the number of carers. It was stated that the team was in place to provide rehabilitation to help people maintain their independence and not to deliver long term care.
• When asked if a similar model was in place elsewhere it was stated that the model had been duplicated by other authorities and that the model had been recognised as best practice.  It had also received awards in recognition of its success.
• In response to concerns raised regarding the use of beds at Ty Pili Pala and the disparity of the length of bed stays at Llandovery and Amman Valley, the Committee was advised that the community hospitals received patients that required a longer term of stay as they would usually require packages of care. It was noted that significant work was being undertaken on how to better utilise these beds.
• In response to concern raised regarding work on the strategic integration between Health and Social Care, the Committee was advised due to significant financial pressures, changes at Chief Executive level and reorganisation within Health Board progress had been delayed but it was stated that the Health Board was still committed to ways of integrated working.
• In answer to a query regarding funding and the employment of staff on temporary contracts, the Committee was advised that staff were permanent employees. It was stated that some of the funding was short term and a cause for concern. There would be no additional funding to grow the team further.

UNANIMOUSLY RESOLVED that the report be noted.