The Care Quality Commission has published its findings following a review of health and social care in the City of York.
This report is one of 20 targeted local system reviews looking specifically at how 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 that there had previously been a lack of trust among the system leaders – including the City of York Council and the Vale of York Clinical Commissioning Group - that had held back the closer integration of services. In the past 12 months, this had improved.
Although there was now willingness for further collaboration at a high level, frontline health and social care services were still working in isolation from each other. Different organisations provided similar services, causing confusion for staff and the public.
Some of CQC’s other findings included:
- People using services were not always receiving the care they needed in the right place. There were delays for people waiting to be discharged from hospital, often due to a lack of seven day services in the local area.
- Care homes were reluctant to accept people who needed to be discharged at the weekend because of past incidents where people had been discharged with no medication or discharge summaries.
- Older people’s transfer home or to a new place of residence was often delayed due to a lack of adult social care provision, care packages and patient choice.
- Reablement services were not always effective: a high proportion of people who received a reablement package still required long term support or further reablement.
- There was no single shared case record within the City of York system. There was a poor history of sharing data and business intelligence across organisations in the system which meant that people often had to repeat their story as they moved between services.
Professor Steve Field, Chief Inspector of General Practice, said:
“In the past there have been strained relationships among leading organisations including City of York Council and Vale of York CCG. There has been a lack of continuity at a senior level, making it difficult to build bridges and so transform services and make integration a possibility."
“In York there are also particular challenges across the system including the recruitment and retention of staff – and it will need all the local organisations in the area to come together to reach a solution."
"Despite the issues that we have found, I am optimistic. We have found evidence of a new appetite across health and social care organisations in York to strengthen relationships, integrate working and provide people with better care. System leaders must work together to implement effective seven day working so that services meet the needs of the local people in a timely and person centred way.”
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For further information please contact CQC Regional Engagement Officer Kerri James by email kerri.james@cqc.org.uk or by phone on 07464 92 9966.
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Despite the issues that we have found, I am optimistic.
Professor Steve Field, Chief Inspector of General Practice