Coventry: CQC publishes its review of how local health and social care systems work together

The Care Quality Commission has published its findings following a review of health and social care services in Coventry.

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.

CQC found there was a system-wide commitment to serving the people of Coventry well. Coventry was at the beginning of its journey in ensuring all services worked well in a ‘joined up way’ together.

However, the review also highlighted some areas where further work is needed to ensure all those responsible for providing health and social care services work effectively together.

Professor Steve Field, Chief Inspector of Primary Medical Services and Integrated Care, said:

"The review found that in general terms the health and social care system, led by Coventry City Council and NHS Coventry and Rugby Clinical Commissioning Group, is working well to ensure it meets people’s needs."

“Staff at the front line of services were committed to providing high quality, person-centred care and we saw good examples of multidisciplinary working."

“There are, however, areas where improvements are needed to ensure people receive the best all round care through the health and social care system in Coventry. We found there was a reliance on ensuring services worked together in a joined up way taking place organically and a lack of pace and shared strategic approach in achieving this."

“We found there wasn’t a shared view of risk across the system and this is among the areas we have highlighted for improvement."

“There was evidence of a developing commitment across the system partners to deliver together through better integrated working within Coventry’s health and social care system and across Coventry and Warwickshire."

“In the past there had been some challenging relationships and silo working, but these were improving and relationships across the system were, for the most part, positive."

“Staff across the system were committed to developing a more person centred, joined up approach."

“We have presented our findings to health and social care system leaders in Coventry so that they can continue to work on bringing joined up care to people living in the city and its surrounding areas.”

Overall CQC reviewers found:

• The Warwickshire and Coventry Sustainability and Transformation Partnership (STP), renamed the ‘Better Care, Better Health, Better Value’ programme, provided the overarching framework for integration between health and social care across Coventry and Warwickshire. There was not yet a shared articulated vision or strategy specifically for future service provision for older people living in Coventry.
• Coventry Health and Wellbeing Board (HWB) agreed the priorities around the strategic direction of health and social care in Coventry, which are laid out in the Coventry Health and Wellbeing Strategy 2016-2019. This provides a plan for reducing health inequalities and improving health and wellbeing for people living in Coventry and is aligned with the ‘Better Care, Better Health, Better Value’ programme.
• Coventry HWB worked closely with Warwickshire HWB to ensure more joined up working across Coventry and Warwickshire’s health and social care systems, but the impact of this as a driver for change was not yet apparent.
• There was an acknowledgement at a strategic level across partner organisations that a focus on preventing hospital admission was as crucial to the effectiveness of the health and care system as enabling safe and timely discharge.
• The annual Public Health Report 2016/17 focused on the needs of younger people and lacked insight into future plans for health promotion and prevention for the older people of Coventry. There was a risk that, as the numbers of older people in Coventry increased; the needs of this section of the population would be overlooked.

This review makes a number of suggestions of areas where the local system should focus on to secure improvement including:

• There needs to be effective joint strategic planning and delivery for the people of Coventry based on the current and predicted needs of the older population, to include British Asian Minority Ethnic (BAME) and hard to reach groups.
• System-wide performance data must be used to drive improvements, implement solutions and set targets in which all parts of the system have a shared responsibility, and provide opportunities for collaborative reflection and learning.
• While acknowledging that there is an alliance between Coventry Health and Wellbeing (HWB) and Warwickshire HWB, the system leaders in Coventry need to build on this and become more engaged with the development of the STP’s ‘Better Care, Better Health, Better Value’ programme.
• A strategic plan for the health and social care workforce in Coventry, linked to the STP’s wider ‘Better Care, Better Health, Better Value’ programme workforce plan, needs to be delivered.
• A joint public engagement strategy needs to be created and delivered to include how the system will reach seldom heard groups.
• A single point of access health and social care navigation system for people and carers to easily find the support and advice they need should be provided.
• Numbers of avoidable admissions from care homes need to be reduced by extending successful initiatives such as the ‘React to Red’ scheme, introducing pharmacist led medication reviews and increasing coverage of GP input into care homes.
• The system should develop a shared view of risk across health and social care by identifying forums where staff groups can come together, build relationships and identify ways to establish a consistent approach to the process of risk assessment and positive risk taking.
• Ensure discharge planning is consistently started at the beginning of a person’s journey through hospital and remains a key focus during their stay. Care home and home care providers to be involved in discharge planning at an early stage of a person’s stay in hospital.
• Improve the processes around medicines on discharge to reduce delays and improve the safety of those who have been discharged to care homes.
• Improve the ability to discharge patients from hospital at weekends by increasing senior clinical decision makers and supply the support needed for care homes to accept weekend discharges for new residents.
• Increase the speed of transfers from hospital to care homes by increasing care home providers’ confidence in assessments.
• Improve the working relationships between the CCG and GPs.

Ends

For further information, please contact Louise Grifferty on 07717 422917 or Regional Engagement Officer, Helen Gildersleeve, on 0191 233 3379.

Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here.

Please note: the press office is unable to advise members of the public on health or social care matters. For general enquiries, please call 03000 61 61 61.